Use of low-value cancer care in practices acquired by private equity firms

Private equity acquisition of medical practices has been associated with increased prices and use of lucrative treatments. Using Medicare data from 2015 to 2021, we compared the prevalence of low-value cancer treatments between private equity-owned and non-private equity-owned practices. The 5 low-value treatments were (1) granulocyte colony-stimulating factors for low-risk chemotherapy, (2) denosumab for castration-sensitive prostate cancer, (3) nab-paclitaxel for breast or lung cancer, (4) the addition of bevacizumab for ovarian cancer, and (5) biologic agents 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 private equity-owned address, adjusted prevalence differences of low-value treatments were -2.8 percentage points (95% confidence interval [CI] = -5.5 to -0.2) for granulocyte colony-stimulating factors, +3.7 percentage points (95% CI = -7.3 to 14.7) for denosumab, -0.7 percentage points (95% CI = -3.9 to 1.5) for nab-paclitaxel, -6.5 percentage points (95% CI = -12.5 to -0.4) for bevacizumab, and -2.9 percentage points (95% CI = -6.0 to 0.2) for biologics. Overall, private equity ownership was not associated with increased prevalence of low-value cancer treatments.