How Medicare Spends $1 Billion a Year on a Device that Kills Cancer
Roughly one in three Medicare beneficiaries diagnosed with prostate cancer today gets a sophisticated form of radiation therapy called IMRT. Eight years ago, virtually no patients received the treatment… Taking advantage of an exemption in a federal law…urologists buy radiation equipment and hire radiation oncologists to administer it. They then refer their patients to their in-house staff for treatment. The bulk of Medicare’s reimbursements goes to the urologists as owners of the equipment…
Treatment options [for prostate cancer] range from IMRT, which costs Medicare as much as $40,000 for a full course of radiation in places such as New York, to a cheap approach known as “watchful waiting,” which means simply monitoring the cancer with regular office visits and tests.
Full article on intensity-modulated radiation therapy.
Hard to believe.
There are so many different treatments for prostate cancer, including the wait-and-watch approach, that making the best decision for treatment can be very difficult. Getting a second opinion can help.
It’s a little disconcerting that whole practices have sprung up to irradiate men’s prostates despite a lack of evidence (or a consensus) that this is the most effective method. Many experts believe there is no evidence that IMRT is better than watchful waiting.
I’d want the choice of therapies, but I suspect that if everyone was paying for this therapy out of their own pockets, it would be a lot cheaper.
Keep in mind that watchful waiting is not appropriate for many prostate cancer cases–especially for younger men or men with more aggressive cancers. IMRT allows the delivery of more radiation to the prostate while sparing surrounding tissues.
The first patient was treated in 1994. It was limited to academic centers at first, so it isn’t surprosing that the article says treatments have risen from zero in eight years.
In 2000, CMS increased payment rates to 4 tmies the rate for conventional therapies (later reduced to three times).
Remember the complaining about the prohibitive cost of expensive CAT scans?