Chemotherapy and supportive drugs constitute 70% of a cancer patient’s medical costs during active therapy. Payers use several approaches to keep those costs affordable including paying lower margins for “buy and bill” oncologists, prior authorization, pathways, or performance-based compensation. Payers also utilize financial tools such as deductibles, copayments, or coinsurance to shift more of the cost of health care coverage to employees or the insured. The strengths and weaknesses of those approaches are reviewed in this article. Policy changes that address drug protection from competition or negotiation, monopoly status of health care systems, and Food and Drug Administration approval of new medications will affect how effective any payer strategy will be in the future.

在积极治疗期间，化学疗法和支持药物占癌症患者医疗费用的70％。付款人使用多种方法来保持这些费用的可承受性，包括为“买和买”的肿瘤科医生支付较低的保证金，事前授权，途径或基于绩效的补偿。付款人还利用诸如免赔额，共付额或共同保险之类的财务工具，将更多的医疗保险费用转移给员工或被保险人。本文介绍了这些方法的优点和缺点。应对药品保护以防止竞争或谈判，医疗保健系统的垄断地位以及食品药品管理局对新药的批准的政策变更将影响未来任何付款人策略的有效性。