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Impact of Intensity-Modulated Radiotherapy on Health Care Costs of Patients With Anal Squamous Cell Carcinoma
- Source :
- Journal of oncology practice. 13(12)
- Publication Year :
- 2017
-
Abstract
- Purpose: Drivers of variation in the cost of care after chemoradiotherapy for the management of anal squamous cell carcinoma (SCC) have not been fully elucidated. We sought to characterize the direct and indirect impact of radiotherapy modality on health care costs among patients with anal SCC. Patients and Methods: A retrospective cohort study was performed using the 2014 linkage of the SEER-Medicare database. We identified 1,025 patients with anal SCC diagnosed between 2001 and 2011 and treated with chemoradiotherapy. Propensity score matching was used to balance baseline differences between patients treated with intensity-modulated radiotherapy (IMRT) and those treated with three-dimensional conformal radiotherapy (3D-CRT). Differences in total, cancer-attributable, and procedure-specific costs between groups were measured. Results: Radiation-related, patient out-of-pocket, and total costs in the 1-year period after radiotherapy start were all higher for the IMRT group than the 3D-CRT group (median total cost, $35,890 v $27,262, respectively; P < .001). Patients who received IMRT had lower cumulative costs associated with urgent hospitalizations and emergency department visits at both 9 months and 1 year after treatment start compared with a matched cohort of patients who received 3D-CRT (median, $711 v $4,957 at 1 year, respectively; P = .021). Conclusion: Although total costs of care were higher for IMRT compared with 3D-CRT, primarily as a result of higher radiotherapy-specific costs, IMRT was associated with decreased unplanned health care utilization costs starting at 9 months after treatment start. Radiotherapy-centered episodes of care may need to encompass a longer time horizon to capture the full cost savings associated with more advanced radiation modalities.
- Subjects :
- Oncology
Male
medicine.medical_specialty
medicine.medical_treatment
Medicare
Article
03 medical and health sciences
0302 clinical medicine
Internal medicine
Health care
Carcinoma
Medicine
Humans
030212 general & internal medicine
Aged
Retrospective Studies
Oncology (nursing)
business.industry
Health Policy
Anal Squamous Cell Carcinoma
Retrospective cohort study
Radiotherapy Dosage
Chemoradiotherapy
Health Care Costs
medicine.disease
Anus Neoplasms
United States
Surgery
Radiation therapy
030220 oncology & carcinogenesis
Propensity score matching
Carcinoma, Squamous Cell
Female
Intensity modulated radiotherapy
Radiotherapy, Intensity-Modulated
Radiotherapy, Conformal
business
Subjects
Details
- ISSN :
- 1935469X
- Volume :
- 13
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Journal of oncology practice
- Accession number :
- edsair.doi.dedup.....e13ad74234f3dd59985569810cf604d8