Radiation therapy costs depend more on the location where the treatment is being provided and the type of facility that is providing the treatment than on factors relating to the type of patient or disease, according to a study published this month in the International Journal of Radiation Oncology.
The researchers, led by Anthony Paravati, M.D., of the University of California, San Diego, used data from the Surveillance, Epidemiology, and End Results Medicare database to identify 19,304 patients identified with non-metastatic breast, prostate, or lung cancer between 2004 and 2007. They determined the costs of radiation treatments for each patient by adding reimbursement amounts from Medicare billing claims for radiation treatment, weekly management and treatment planning. The cost includes the amounts paid by Medicare and the amount owed by the beneficiary.
Geographical variations in Medicare spending has been an ongoing concern for several decades. Several years ago the Institute of Medicine was tasked with investigating the role of geographic variation in healthcare spending and quality for the Medicare population, and last year reported that geography "significantly" correlated to cost and quality variations not only in the U.S., but that there were variations within regions as well.
Paravati and colleagues determined that the median adjusted cost of a course of radiation was $10,081 for breast cancer, $10,591 for lung cancer and $24,308 for prostate cancer.
"For all three disease sites, patient- or tumor-related factors such as age, race, gender, comorbidity, T-stage, N-stage, tumor grade and surgery altogether accounted for only 1 to 3 percent of cost variation," the researchers wrote, adding that providing the treatment at an academic center didn't account for any of those cost variations.
They went on to explain that the individual radiation provider was responsible for 27 percent, 41 percent, and 62 percent of the total cost variations for breast, lung, and prostate cancer respectively, and that those cost variations were linked to differences in geographic locations around the U.S., as well as the type of practice location (hospital or free-standing clinic).
"Future research should focus on determining whether this cost variability translates into improved outcomes, though these findings suggest potential inefficiency in healthcare expenditure in radiation oncology," Paravati and his colleagues said.
To learn more:
- see the study in the International Journal of Radiation Oncology