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Go Ahead. Just Try Comparing Cancer Treatment Costs.

Study of posted prices finds wild variations and missing data

Cancer patients trying to find out what their treatment will cost face an up-hill battle despite a federal rule that requires hospitals to publicly list standard charges for services and procedures, a new study shows.

In a report published in JAMA Oncology, researchers set out to learn what hospitals charge for a standard radiation treatment for prostate cancer. They searched the websites of 63 National Cancer Institute–designated cancer centers for the listed cost for simple intensity-modulated radiation therapy (IMRT) for prostate cancer. They discovered the information was inconsistent or missing.

While 52 centers (83%) published the cost, three did not list a cost for a simple IMRT, and eight did not publish costs for any procedure. For a standard 28-fraction course of prostate irradiation treatment, the charges ranged from $18,368 to $399,056—more than 21 times the lowest cost. The mean cost of $111,729 was 10.1 times the price paid by Medicare. In addition, the published costs covered a single procedure and not the entire course of care, and no information was provided on discounted rates that private insurance companies may have negotiated.

The lack of common terminology, unbundled cost reporting, wide range in pricing, and listing of non-negotiated rates limit the information's value, especially when a person is trying to estimate or compare the cost of care, said the study’s corresponding author, Trevor Royce, MD, MS, MPH, of the University of North Carolina Lineberger Comprehensive Cancer Center. "How can consumers and providers be expected to make informed decisions, such as pursuing high-value care, if they do not know the costs?"

Price transparency is seen by some as an approach to address the high cost of care. A January 2019 price transparency mandate by the Centers for Medicare & Medicaid Services allows patients to look up the prices of cancer treatment services at U.S. hospitals.

"Providing cost data that is easy to understand and consistent from one hospital to the next is an important step in helping people to make informed decisions about their care and the associated costs," said Ankit Agarwal, MD, MBA, the paper's first author and co-chief resident of radiation oncology at the UNC School of Medicine. "This information also may lead to a more competitive health care marketplace, which could drive down costs if hospitals compete for patients."

Sources: University of North Carolina Lineberger Comprehensive Cancer Center, January 16, 2020; JAMA Oncology, January 16, 2020

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