Room: Phillips 231
Time: Mon 13:15 PM-14:45 PM

Some Economics of Cancer Screening, Detection and Treatment

Chair: Joseph Newhouse (Harvard University)

Session Description

Cancer is the second leading cause of death in the United States and is one of the 5 leading causes of death in all age groups. “Best practices” for cancer screening and treatment are often ambiguous and sometimes quite controversial. In this session, we explore the role of insurance coverage and financial incentives in determining cancer screening, detection and treatment. The first two papers study the impact of insurance on cancer screening and detection. One considers insurance mandates for mammograms and finds that coverage significantly increases mammography screenings for those age-groups targeted by the policy. While the focus of the first paper is in some sense on mandated benefit design on screening within the insured population, the second paper considers the effect of insurance coverage itself on cancer detection. Specifically, it focuses on the change in insurance coverage at age 65, as people transition to Medicare, on cancer detection. It finds a very large Medicare-related increase in cancer detection that is disproportionately concentrated in the previously uninsured population. The final paper in this session studies cancer chemotherapy treatment in the Medicare population. Focusing on a recent change to the way Medicare reimburses for cancer drugs, this paper finds that physicians actually increase overall chemotherapy treatment in response to a payment reduction but substitute away from drugs that experienced the largest cuts in margins. Together these papers highlight the importance of insurance coverage, benefit design and payment policies in cancer detection and treatment.

Key Terms None

Session Organizer: Mireille Jacobson (RAND)

---

Presentations

1. Insurance Mandates and Mammography

   Presenter: Christopher Carpenter (University of California, Irvine)

   Discussant: Kosali Simon (Cornell University)

2. Does Medicare Affect Cancer Health Outcomes?

   Presenter: Srikanth Kadiyala (University of Washington)

   Discussant: Nicole Maestas (RAND)

3. The Impact of the Medicare Modernization Act on Cancer Chemotherapy Treatment

   Presenter: Mireille Jacobson (RAND)

   Discussant: Sean Nicholson (Cornell University )