Dr. David Gruen, director of Women’s Imaging at Stamford Hospital, reviews 3D images Photo: Stamford Hospital
Medicare-funded breast cancer screenings jumped 44 percent from $666 million to $962 million from 2001 to 2009, yet those added costs did not improve early detection rates among the 65 and older Medicare population, according to a Yale School of Medicine study published recently in the Journal of the National Cancer Institute.
The increase was due mostly to the use of costlier digital mammography ($115 per screening) compared to film mammography ($73 per screening), along with newer and expensive screening and adjunct technologies, including breast ultrasound, magnetic resonance imaging (MRI) and biopsy. The study is the second from Yale since January 2013 to conclude that increased Medicare spending for breast cancer screening does not necessarily translate into better outcomes.
The latest study has spurred debate about the cost and value of mammography in Medicare beneficiaries, particularly women 75 and older. Some physicians recommend continued screening, while others argue that it is unnecessary and only fuels anxiety among older women.
And with Medicare beneficiaries comprising one-third of the 37 million American women screened each year, the cost implications of breast-screening procedures on the Medicare budget are significant, researchers said.
“Clinicians and patients need to start thinking about the bang they are getting for their buck,” said Dr. Anees Chagpar, director of the Breast Center – Smilow Cancer Hospital at Yale-New Haven, and a co-author of the study. “We must be cognizant of our use of technology and healthcare dollars.”
“Our country and health system have finally recognized that this aggressive and dramatic rise in health care costs is not sustainable,” said Dr. Cary Gross, director of the Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale Cancer Center and one of the study’s lead authors. “We need to make choices about how to prioritize our healthcare spending.”
But some breast cancer experts worry that older women who are healthy will misinterpret the Yale findings to mean they don’t need an annual mammogram.
To read full story: http://c-hit.org/2014/11/09/medicare-costs-for-breast-cancer-screenings-soar-but-benefits-remain-unclear/
