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Medicare Patients Given Fewer Treatment Options

Cheryl Clark, for HealthLeaders Media, March 5, 2012

The research group sent surveys to 800 patients for whom Medicare claims records indicated they'd had prostate cancer surgery and 800 who'd undergone a non-emergent stent during the last six months of 2008. Some 685 prostate cancer patients' and 472 stent patients' responses were included. The patients were given a $5 in cash as an incentive.

Fowler emphasized there is good evidence that other options in prostate cancer, such as brachytherapy, eternal beam radiation or conservative management, has equivalent survival benefit for people over age 65.

Likewise, medical management and changes in diet and exercise can relieve angina pain for patients with coronary artery disease, but 54% of the stent patients had no arm or chest pain in the month preceding the sampled stent procedure.

Several recent reports in medical journals increasingly call attention to the proliferation of unnecessary or inappropriate stenting procedures by interventional cardiologists, including one July 6 in the Journal of the American Medical Association, which found that of elective percutaneous coronary interventions, 50.4% were appropriate, 38% uncertain and 11.6% inappropriate.

But Fowler's new study was not about which procedure was best for each patient.

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