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[Is cytoreductive surgery with HIPEC adequately funded?]
Can Yurttas1, Sarah Kalmbach2, Emilia Ansorge2
1Klinik für Allgemeine, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Deutschland. can.yurttas@med.uni-tuebingen.de.
Chirurgie (Heidelberg, Germany)
|February 19, 2025
Summary
Cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is underfunded by the German diagnosis-related group (DRG) system. This analysis reveals that treatment costs exceed reimbursement, necessitating a DRG system reform for complex oncological treatments.
Area of Science:
- Oncology
- Surgical Oncology
- Health Economics
Context:
- Cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is a specialized treatment for peritoneal metastases.
- Hospitals face financial challenges due to the high cost intensity of this multimodal therapy.
Purpose:
- To identify factors influencing the cost and revenue of CRS/HIPEC within the German diagnosis-related group (DRG) system.
- To analyze the financial viability of CRS/HIPEC under current reimbursement structures.
Summary:
- A 2017-2021 analysis of 173 patients undergoing CRS/HIPEC showed average hospitalization of 16.1 days and ICU stay of 2.2 days.
- Average DRG revenue was €21,658.48, while total costs averaged €23,764.77, resulting in a deficit of €2,106.29 per patient.
- Increased length of stay in ICU and overall hospitalization positively correlated with higher treatment costs and DRG revenue.
Impact:
- The study highlights that the German DRG system significantly underfunds the complex CRS/HIPEC treatment.
- A reform of the DRG system is recommended to better accommodate high-cost oncological treatments like CRS/HIPEC.
- Improved reimbursement could ensure the continued availability of this life-extending therapy for selected cancer patients.
