![]() ![]() Number of practices and patients in those practices receiving chemotherapy, 2005–2012. Use of intravenous chemotherapy-agents included and not included. ![]() Food and Drug Administration Actions for Bevacizumab. tif_ pdf_ etc._: Supplemental Digital Content Table 1. Normand, PhD, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, Phone: 61, Fax: 61 Chernew, PhD, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, Phone: 61, Fax: 61 Landon, MD, MBA, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, Phone: 61, Fax: 61 McNeil, MD, PhD, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, Phone: 61, Fax: 61īruce E. Michael McWilliams, MD, PhD, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, Phone: 61, Fax: 61īarbara J. Huskamp, PhD, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, Phone: 61, Fax: 61ĭeborah Schrag, MD, MPH, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, Phone: 61, Fax: 61 Keating, MD, MPH, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, Phone: 61, Fax: 61 These findings suggest that interventions targeted to practices have potential for decreasing low-value use of high-cost cancer therapies. CONCLUSIONS:Use of bevacizumab varied widely across oncology practices, particularly for lower-value indications. Variation was less for higher-value than lower-value uses. We observed substantial variation in use the adjusted odds ratio (95% confidence interval) of bevacizumab use was 2.90 higher (2.73-3.08) for practices 1 SD above versus one standard deviation below the mean. RESULTS:We observed relatively rapid diffusion of bevacizumab, particularly in independent practices and larger versus smaller practices. ![]() We used hierarchical models with practice random effects to estimate the between-practice variation in the probability of receiving bevacizumab and to identify factors associated with use. MEASURES:Diffusion of bevacizumab (cumulative time to first use and 10% use) in practices, variation in use across practices overall and by higher versus lower-value use. PARTICIPANTS:Random 20% sample of 236,304 Medicare fee-for-service beneficiaries aged above 65 years in 2004-2012 undergoing infused chemotherapy for cancer. SETTING:A total of 2329 US practices providing cancer chemotherapy. RESEARCH DESIGN:Population-based observational study. OBJECTIVES:Examine diffusion of bevacizumab, a novel (in 2004) and high-priced biologic cancer therapy, among US oncology practices during 2005-2012 and assess variation in use across practices. Understanding diffusion and use of new oncology therapies is important, given substantial increases in prices and spending on such treatments. #Surviving high school episodes zip file driver#BACKGROUND:Technological advances can improve care and outcomes but are a primary driver of health care spending growth. ![]()
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