Imaging costs for Medicare cancer patients on the rise

Apr 29 2010

A study in the Journal of the American Medical Association analyzed data from Medicare cancer patients to determine the change in imaging use for this group.

According to Bloomberg Businessweek, PET, or positron emission tomography, scans for Medicare patients increased at the most rapid pace in the group, though costs for all types of scans rose. "Average two-year costs of all types of imaging tests for cancer, including CT scans and X-rays, rose at double the rate of overall cancer treatment costs," according to the report. "The increase in use of PET scans 'has probably gotten worse' after the study ended in 2006 because Medicare has expanded reimbursement for the tests to more types of cancer, said David Soffa, senior vice president of medical affairs for American Imaging Management, a Chicago-based subsidiary of WellPoint Inc., an Indianapolis-based health insurer. The tests usually cost $2,000 to $3,000, though Medicare reimburses less than $2,000, he said" (Olmos, 4/27).

The Associated Press/MSNBC: The study looked largely at cost, and not at effectiveness of the imaging tests. "While these sophisticated scans typically provide more detailed images than conventional X-rays, the study didn't look at whether their increasing use has improved cancer patients' survival. Some small studies have suggested the scans can improve treatment but evidence is lacking on how they affect survival." The AP notes that "lung cancer patients diagnosed in 2006 had on average almost six CT scans in the next two years, versus four scans for those diagnosed in 1999"  (Tanner, 4/27). 

Reuters: "[T]he study is the first to look specifically at the increasing use and cost of scans done on cancer patients." Though PET scans are the most expensive type of imaging test, they can be used for many purposes, the report said. "In breast cancer patients, PET scans can be used to determine whether women are responding to biologic drugs, which can cost more than $5,000 per month."

Researchers found "that while the overall treatment costs during a two-year period increased at a rate of 2 to 5 percent per patient, the cost of imaging those patients rose by 5 to 10 percent per patient"  (Steenhuysen, 4/27).