Need for Consistency in Radiation Treatment Costs Among Medicare Enrollees

A study published in the Journal of Oncology Practice by researchers at the Moores Cancer Center at the University of San Diego has identified significant variability in the cost of radiation therapy among Medicare enrollees.

“Understanding why costs vary for radiation therapy helps policy makers evaluate the efficiency of the current fee-for-service Medicare reimbursement system. Such insights are likely to shape policy reforms in the near-future,” said Anthony Paravati, MD, first author of the study.

Using Medicare reimbursement amounts from the SEER database for radiation therapy among more than 55,000 breast, lung, or prostate cancer patients diagnosed between 2004 and 2009, the researchers examined the extent to which the tumor type, radiation therapy provider, or the patient influence the cost of radiation treatment. The results of the multivariable regression analysis were surprising. The median cost of a single course of radiation therapy was $8600 ($7300 to $10,300) for breast cancer, $9000 ($7500 to $11,100) for lung cancer, and $18,000 ($11,300 to $25,000) for prostate cancer. The authors found that the tumor type and patient characteristics influenced less than 3% of the cost. A majority of the variability, the authors found, stemmed from practice type, geographical location of the treatment center, and the radiation provider.

“Factors unrelated to the individual patient accounted for the majority of variation in the cost of radiation therapy, suggesting potential inefficiency in health care expenditure,” the authors write. They suggest identifying whether this variability translates into improved patient outcomes and quality of care for further evaluation of current reimbursement practices.