Prostate cancer patients would pay $2,000 more for better, MR-US, biopsies
by John W. Mitchell
, Senior Correspondent | May 01, 2017
As the cost of health care spending shifts to patients through coverage limits and higher deductibles, researchers at Loyola University Medical Center found that men are willing to pay about $2,000 more out-of-pocket for a new, high-tech biopsy that significantly improves diagnostic and treatment accuracy.
The study centered around a relatively new imaging method for diagnosing prostate cancer, MR-US prostate biopsy. Loyola was the first center in Illinois to offer the procedure.
"We found that patients are willing to pay more for new technologies, for perceived benefits," Dr. Gopal N. Gupta, assistant professor of urology, radiology, and surgery at Loyola Medicine told HCB News. "We have had more and more patients willing to pay out of pocket for this technology when insurance denies it, and they are also angry with insurers who do not pay for this procedure."
The interdisciplinary study was conducted by the Loyola Stritch School of Medicine and the Loyola Chicago Quinlan School of Business. It was recently published in the journal Urology Practice.
The technique fuses MR images with ultrasound imaging to create a detailed, 3-D view of the prostate. This improved view helps physicians perform biopsies with much higher precision and increases prostate cancer detection.
This, compared to the less dependable standard biopsy protocol that requires 12 needle sticks into the prostate and, according to Gupta, has many inherent risks including bleeding and life-threatening infections.
The researchers surveyed 202 men age 55 to 70 in a urology clinic. They were asked to imagine that they had $2,000 of their money in a health savings account. These accounts are commonly linked with high-deductible insurance plans. The test subjects said they were willing to pay between $1,598-2,034 more for an exam that increased the likelihood of detecting prostate cancer at a higher frequency rate of between 8 to 20 percent.
"Our study gives novel insight to what patients’ value most when it comes to prostate cancer biopsy; they value specificity or the knowledge that they do not have cancer at this time," said Gupta. "This is very important, as many men undergo repeated negative biopsies due to rising PSA."
Depending upon the hospital, MR-US prostate biopsy costs between $500-1,570 more than the standard invasive needle stick biopsy.
"Any technology to improve on biopsy sensitivity/specificity will lead to better outcomes and lower long-term costs ," said Gupta. "We now have 'eyes' into the prostate where we did not before. We are rethinking all strategies related to prostate cancer detection, risk stratification, and treatment, given this new technology."
Currently, there is no increased reimbursement for clinicians offering MR-US, which he said is "problematic." But he believes that as the technology becomes more widely available, insurance companies are more likely to cover the procedure.
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