Use of Low-Value Cancer Care in Practices Acquired by Private Equity Firms

Private equity (PE) acquisition of medical practices has been associated with increased prices and use of lucrative treatments. Using Medicare data 2015 to 2021, we compared the prevalence of low-value cancer treatments between PE-owned and non-PE-owned practices. The five low-value treatments were: granulocyte colony stimulating factors (GCSF) for low-risk chemotherapy; denosumab for castration sensitive prostate cancer; nab-paclitaxel for breast or lung cancer; addition of bevacizumab for ovarian cancer; and biologic drugs with biosimilar alternatives. The primary outcome was receipt of a low-value treatment. Comparing patients diagnosed when their oncologist was vs was not practicing at a PE-owned address, adjusted prevalence differences of low-value treatments were: -2.8%-points (-5.5 to -0.2) for GCSF; +3.7%-points (-7.3 to 14.7) for denosumab; -0.7%-points (-3.9 to 1.5) for nab-paclitaxel; -6.5%-points (-12.5 to -0.4) for bevacizumab; and -2.9%-points (-6.0 to 0.2) for biologics. Overall, PE ownership was not associated with increased prevalence of low-value cancer treatments.