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May 4, 2010

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Cost of scans for cancer patients rising sharply

THE cost of imaging used on Medicare cancer patients is growing at twice the rate of overall cancer treatment costs as doctors order more scans and recommend more advanced tests, say researchers in the United States.

Imaging is already the fastest growing expense for Medicare, but the study is the first to look specifically at the increasing use and cost of scans on cancer patients.

They said the use of positron emission tomography or PET scans, which show both anatomy and organ function, grew the fastest. PET scans cost six times more than an advanced type of X-ray called a computed tomography or CT scan.

"As newer, more expensive imaging technologies are used more frequently, the overall cost of imaging is going to increase," said Michaela Dinan, a researcher at Duke University who led the study published in the Journal of the American Medical Association.

Cancer costs the nation US$228.1 billion, including US$93.2 billion in direct medical costs, and cancer-related costs are expected to grow faster than any other area of health care, the team said.

Duke researchers studied eight different imaging technologies used on roughly 100,000 patients enrolled in the federal Medicare program for the elderly who were newly diagnosed with various types of cancer between 1999 and 2006.

They 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.

"Imaging costs among Medicare beneficiaries with cancer increased from 1999 through 2006, outpacing the rate of increase in total costs among Medicare beneficiaries with cancer," the team wrote.

The cost of PET scans on average increased at an annual rate of 36 to 53 percent, but the overall number of PET scans stayed low.

Patients with lung cancer and lymphoma faced the highest imaging costs among all cancer patients - more than US$3,000 on average during the first two years of treatment.

Although imaging costs are rising much more rapidly than other cancer treatment costs, imaging costs comprise only 6 percent of the total Medicare budget for cancer patients, the authors said.

Some policy experts have speculated that increased use of imaging among Medicare patients resulted from cost shifting after the 2003 Medicare Modernization Act slashed reimbursement rates for chemotherapy services.

But the increases may also be the result of the availability of more advanced technology.


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