Everything is a bargain relative to something else. That misses the point.
Medicare (CMS) has made it abundantly clear that the cost curve for medical care and especially oncology needs to be bent. It is very clear that they are not going to "grow a pair" and confront pharma with cost controls. Therefore, they are focusing all of their attention on physicians. Rather than reducing the cost of drugs, they are "encouraging" oncologists to prescribe less expensive treatments. Enforcement will come through mutual gain/pain; in other words, if you save Medicare money they will share cost savings with you, if you go over the limit then you eat the excess.
Looking at our practice and others (as medgator alludes to above) radiation is actually highly cost efficient and clinically effective. However, the gatekeepers of all things financial will be Medical Oncologists, not Radiation Oncologists. Therefore, unless you are in a well-integrated group, Rad Oncs run the risk of seeing fewer patients for more expensive and less effective immunotherapies for the sake of cost containment ("penny-wise, pound foolish.")
This is the reality of private practice today and which is why I (and others) automatically do not jump with joy whenever a new trial is published with a super expensive drug with marginal benefit.
