The incidence of gastrointestinal (GI) complications following intensity-modulated radiation therapy (IMRT) for prostate cancer is considerable, and GI complications in this setting add more than $3,000 to the cost of care for a Medicare beneficiary, say the authors of a large study from Harvard Medical School, Brigham and Women’s Hospital, and Dana-Farber Cancer Institute in Boston that Urology Times Editorial Consultant J. Brantley Thrasher, MD, called an important examination of cost versus benefit.
“Medicare spending associated with post-IMRT GI complications is often in excess of 10% of IMRT cost,” said first author Monica J. Wood, who presented the findings at the Genitourinary Cancers Symposium in Orlando, FL.
“It’s important to know that even though GI complications with IMRT are fewer compared with other forms of radiation therapy, there’s still a significant amount of GI complications that are associated with increased costs from the spender’s perspective. With our health care system, which is under a lot of cost control pressure from payers and consumers, it’s important for us to know whether these complications are associated with a significant amount of spending,” said Wood, a medical student at Harvard Medical School who worked on the study with Paul Linh Nguyen, MD, and co-authors.
Using Surveillance, Epidemiology, and End Results-Medicare linked data, researchers examined the incidence and predictors of GI complications in 11,781 men with non-metastatic prostate cancer who underwent definitive IMRT and had no pre-existing GI toxicity and at least 36 months of follow-up after initiating IMRT. Annual incremental spending was defined as the total Medicare payments in the year after development of a first GI complication minus the total Medicare payments in the year preceding the diagnosis of prostate cancer.
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