Turnaround time for treatment of patients with colorectal cancer

Abstract

17548 Background: Colorectal cancer is one of the leading causes of deaths in the United States. Depending on cancer staging and other co-morbidities, patients require either first, second, or third line chemotherapy regimens, which are paid for through a health insurance plan. Based on insurance plan policies and criteria, the turnaround time for treatment can take weeks before treatment initiation. Chemotherapy induced neutropenia and/or anemia may result from chemotherapy. Methods: A retrospective study was performed on patient charts in which 180 patients, in groups of 20, represented six of the major insurance companies seen in the Westchester Hematology/Oncology Private Practice. These charts were analyzed to calculate the average turnaround time for treatment administration and the correlation between this turnaround time and the cost of treatment. Results: Insurance companies which required specialty pharmacies and preauthorizations such as AETNA, Blue Cross Blue Shield (BCBS), and HIP had the longest turnaround times for treatment, averaging from 9–19 days for all types of treatment. This was followed by insurance companies that required patients to obtain treatment from a local pharmacy such as UHS and GHI, averaging from 6–15 days for all types of treatment. Medicare, which allowed patients to obtain treatment directly from the office had the shortest turnaround time in treatment, averaging from 3–11 days. Patients with chemotherapy induced neutropenia/anemia were forced to stop treatment until medications were obtained and bloodwork returned to normal, further delaying the turnaround time for subsequent treatments. In addition there was a direct correlation between the turnaround time for treatment and the cost of treatment for all insurance companies. Conclusion: Based on insurance policy, the initiation of chemotherapy treatment can be delayed. Studies indicate that delays in treatment can increase the log growth of cancer cells. Patients and physicians are forced to wait, appeal and sometimes fight with the insurance company for treatment reimbursement. In addition, chemotherapy induced neutropenia/anemia requires treatment to be halted. Studies indicate that such dose delays may allow more tumor regrowth between cycles. No significant financial relationships to disclose.