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IMRT for head and neck cancer: Cost implications
Ali Razfar1, Jagmeet Mundi1, Tristan Grogan2
1Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA.
American Journal of Otolaryngology
|December 15, 2016
Summary
Intensity-modulated radiotherapy (IMRT) is increasingly used for head and neck cancer, but it is significantly more expensive than conventional radiation therapy (XRT). Further studies are needed to determine if IMRT’s higher cost improves patient outcomes.
Area of Science:
- Oncology
- Radiation Oncology
- Health Economics
Background:
- Intensity-modulated radiotherapy (IMRT) offers reduced side effects in cancer treatment.
- IMRT adoption has outpaced evidence from prospective outcome studies.
- Head and neck cancer treatment involves surgery, conventional XRT, and IMRT.
Purpose of the Study:
- To compare the Medicare reimbursement costs of surgery, IMRT, and conventional XRT for head and neck cancer.
- To identify factors influencing cost differences between these treatment modalities.
Main Methods:
- Analysis of Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data (2000-2007).
- Inclusion of 14,748 patients with head and neck carcinoma meeting specific criteria.
- Comparison of treatment costs based on Medicare payments.
Main Results:
- IMRT usage rose from 1.5% to 48.6% between 2000 and 2007, while conventional XRT decreased.
- Mean cost for IMRT was $101,099 versus $42,843 for XRT.
- Early-stage tumors treated with IMRT cost $95,047, compared to $32,296 for XRT and $18,140 for surgery alone.
Conclusions:
- IMRT is now a primary treatment for head and neck cancer.
- IMRT is substantially more costly than traditional radiation therapy.
- Prospective studies are essential to link IMRT's higher cost to improved patient outcomes.
