Variations in Insurance Coverage for Autologous Bone Marrow Transplantation for Breast Cancer

To the Editor: In concluding that the current process for making decisions about coverage of high-dose chemotherapy for breast cancer is “arbitrary and capricious,” Drs. Peters and Rogers (Feb. 17 issue) 1 assume that . . . only insurers have a financial interest in making determinations about coverage. At the commonly quoted price of $150,000 per course of treatment, however, treatment of the 533 women in their analysis represents an annual income of $20 million to their institution alone. Institutions, providers, and suppliers all benefit substantially from insurance coverage for this treatment. Though the authors indicate otherwise, publication of their article . . .