PROSTATE CANCER: Medicare Change May Limit Men’s Options
California intends to adopt the "Least Costly Alternative" (LCA) policy for reimbursing Medicare prostate cancer patients, according to a special report released last week by the Education Center for Prostate Cancer Patients (ECPCP). The center charges that the policy "forces prostate cancer patients and their physicians to base medical decisions solely on the cheapest available treatment and is being enacted without regard to a patient's choice." For instance, patients on hormone therapy will only be reimbursed for the cost of the cheapest drug -- the difference in price for a more expensive alternative must be paid for out-of-pocket. "If a patient is unable to afford this, then he must switch drugs whether or not the patient and his doctors believe the treatment is best," the Oroville Mercury Register reports. Fred Mills, West Coast director and cofounder of ECPCP, said, "If Medicare is allowed to continue along this path, the LCA policy may establish a dangerous precedent." Executive director and cofounder James Lewis added, "Up until now, Medicare has not succumbed to restricting choice, a movement that has already been met in the private sector with outrage by patients and the medical community. This new policy, however, is Medicare's first step in that direction." The policy is being implemented state-by-state, with South Carolina, Florida and a number of other states already on board. National Heritage Insurance Company, the Medicare contractor for Northern California, "is only accepting public comments on the proposed policy until Dec. 13" (Draper, 11/24).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.