Cost of imaging cancer patients rising sharply

CHICAGO (Reuters) - 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, U.S. researchers said on Tuesday.

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 done 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 $228.1 billion, including $93.2 billion in direct medical costs, and cancer-related costs are expected to grow faster than any other area of healthcare, 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.

MEDICARE CHANGES

“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, the team 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.

Patients with lung cancer and lymphoma faced the highest imaging costs among all cancer patients -- more than $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.

“We definitely saw an increase in the most costly imaging services for patients with cancer. However, we can’t determine whether the trends we observed were a direct response to the reimbursement changes in 2003,” Dr. Kevin Schulman of Duke said in a statement.

He said use of imaging increased throughout the study period, both before and after the reimbursement changes.