Medicare Costs Analysis Indicates Need for Decreasing Use of Biopsies as Diagnosis Tool for Lung Cancer
More than 43 percent of $38.3 million in diagnostic costs attributed to biopsies for patients with ultimately negative lung cancer diagnosis
Chicago, IL — Biopsies were found to be the most costly tool prescribed in lung cancer diagnosis, according to research presented today at the 2014 Chicago Multidisciplinary Symposium in Thoracic Oncology. The Symposium is sponsored by the American Society of Clinical Oncology (ASCO), the American Society for Radiation Oncology (ASTRO), the International Association for the Study of Lung Cancer (IASLC) and The University of Chicago Medicine.
The study examined the utilization rates and estimated the Medicare costs of the lung cancer diagnostic workup in patients who had an abnormal chest computed tomography (CT) scan. The results of this study show that the total diagnostic workup cost for the study sample of patients was $38.3 million. Of the total diagnostic workup cost, 43.1 percent ($16.5 million) is attributed to the biopsy costs for the 761 patients in the study sample who had negative biopsies and who were not diagnosed with lung cancer during the following year.
The retrospective study used a random 5 percent sample of Medicare beneficiaries from January 1, 2009 through December 31, 2011. From that sample, 8,979 eligible patients were identified who were 65 to 74 years old with an abnormal chest CT scan between July 1, 2009 and December 31, 2010. The date of a patient’s abnormal chest CT scan was defined as the index date, and an abnormal scan was described as a scan showing swelling, a mass or lump on the lung, or other respiratory symptoms or diseases within seven days of the CT scan. Patients were excluded from the study if during the six month pre-index period they had a diagnosis of any cancer, pneumonia, atelectasis (a complete or partial collapse of a lung or lung lobe), and/or tuberculosis or if they were not continually eligible during the pre-index period and the 12-month follow-up period. Continue>
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