I took exception to a number of the comments made by Rena Conti, PhD, in The ASCO Post (“Health-Care Reform Is Changing the Oncology Landscape,” October 15, 2014, page 1).

I realize that The ASCO Post is not a peer-reviewed and indexed publication, but as an ASCO member, I also recognize that the publication may be perceived to reflect the position of ASCO.  A number of the comments that Dr. Conti makes are accurate; however, her assertion that there are excess profits for physicians in private practice with the administration of chemotherapy is absurd.

For many of us in small practices, practicing in less affluent areas, it is a struggle just to maintain our practices. For example, in our practice, we have been unable to give raises to our employees for over 3 years, and all of our providers have had reductions to their salaries.

I believe Dr. Conti misses the point in terms of the chemotherapy drugs. If you take a $10,000 drug and mark it up 6% or 20%, it is still expensive. If you take a $100 drug and mark it up 6% or 20% it is still relatively inexpensive. My point is that the biggest drivers of the high cost of the chemotherapy drugs at this time are the suppliers and manufacturers, and not the ­providers.

Certainly, Dr. Conti is correct in saying that there is insufficient comparative effectiveness research and so forth, but her comment about chemotherapy profits to physicians is off base in my opinion, particularly for physicians in non–hospital-based practice. ■

—Peter R. Watson, MD
Kinston Medical Specialists, PA
Kinston, North Carolina