Imaging use, costs skyrocket for Medicare cancer patients

The use and cost of diagnostic imaging for Medicare patients who have cancer increased dramatically over a recent seven-year period, according to a study by researchers from Duke University in Durham, N.C.

Imaging costs for Medicare beneficiaries outpaced the rate of increase in total health care costs among Medicare beneficiaries with cancer, the report concluded. It appeared in the April 28 Journal of the American Medical Association.

Imaging is already the fastest-growing expense for Medicare, but it had not been thoroughly examined for cancer beneficiaries. Michaela A. Dinan, of the Duke Clinical Research Institute, and colleagues analyzed more than 100,000 cancer cases from 1999 through 2006, including patients with breast cancer, colorectal cancer, leukemia, lung cancer, non-Hodgkin lymphoma and prostate cancer.

With each cancer type, the number of positron emission tomography scans per beneficiary increased by an average annual rate of 36% to 53%. Half of patients with lung cancer or lymphoma had PET scans. This group had the largest increase in costs, exceeding an average of $3,000 within two years of the patients' diagnoses.

Increases also occurred in the use of bone density scans, echocardiograms, magnetic resonance imaging and ultrasound. By 2005, one-third of beneficiaries with breast cancer had received bone scans.

The researchers also found that for all cancer types, average two-year imaging costs per beneficiary increased 5% to 10% per year, a rate at least double that of the increase in overall health care costs. Imaging costs for all of the cancers studied also accounted for a larger percentage of total costs in the 2006 group than in all previous years, the report found (link).

"Emerging technologies, changing diagnostic and treatment patterns, and changes in Medicare reimbursement are contributing to increasing use of imaging in cancer," the authors wrote.