New Breast Cancer Radiotherapy Technology Confers Higher Complications and Costs Before Effectiveness Proven
A Medicare Data Analysis
Bibliographic Data
| ID | 13775005 |
|---|---|
| Authors | Heather T Gold (0000-0002-5896-0499, NYU Langone Health, New York, USA, corresponding author), Dawn Walter (0000-0001-5627-2337, NYU Langone Health, New York, USA), Eleni Tousimis (MedStar Georgetown University Hospital, Washington, DC, USA), Eleni A Tousimis (0000-0003-3524-5174, MedStar Georgetown University Hospital), Mary Katherine Hayes (Weill Cornell Medicine, New York, NY, USA) |
| Year | 2018 |
| Volume | 55 |
| Pages | 46958018759115-46958018759115 |
| Publication date | 2018-01-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | INQUIRY The Journal of Health Care Organization Provision and Financing (JOURNAL) |
| Journal identifiers | ISSN: 0046-9580 • E-ISSN: 1945-7243 |
| Publisher | SAGE Publishing (PUBLISHER • US) |
| DOI | 10.1177/0046958018759115 |
| PMID | 29502466 |
| OpenAlex | W2789250229 |
| Language | EN |
| References cited | 29 |
A new breast cancer treatment, brachytherapy-based accelerated partial breast radiotherapy (RT), was adopted before long-term effectiveness evidence, potentially increasing morbidity and costs compared with whole breast RT. The aim of this study was to estimate complication rates and RT-specific and 1-year costs for a cohort of female Medicare beneficiaries diagnosed with breast cancer (N = 47 969). We analyzed 2005-2007 Medicare claims using multivariable logistic regression for complications and generalized linear models (log link, gamma distribution) for costs. Overall, 11% (n = 5296) underwent brachytherapy-based RT; 9.4% had complications. Odds of any complication were higher (odds ratio [OR]: 1.62; 95% confidence interval [CI]: 1.49-1.76) for brachytherapy versus whole breast RT, similarly to seroma (OR: 2.85; 95% CI: 1.97-4.13), wound complication/infection (OR: 1.72; 95% CI: 1.52-1.95), cellulitis (OR: 1.48; 95% CI: 1.27-1.73), and necrosis (OR: 2.07; 95% CI: 1.55-2.75). Mean RT-specific and 1-year total costs for whole breast RT were $6375, and $19 917, $4886, and $4803 lower than brachytherapy ( P < .0001). Multivariable analyses indicated brachytherapy yielded 76% higher RT costs (risk ratio: 1.76; 95% CI: 1.74-1.78, P < .0001) compared with whole breast RT. Brachytherapy had higher complications and costs before long-term evidence proved its effectiveness. Policies should require treatment registries with reimbursement incentives to capture surveillance data for new technologies
Brachytherapy · Breast cancer · Cancer · Complication · Confidence interval · Logistic regression · Odds ratio · Radiation therapy · Seroma · Breast Cancer Treatment Studies · Economic and Financial Impacts of Cancer · Global Cancer Incidence and Screening · Internal Medicine · Medicine · Oncology · Surgery
| Citation velocity | historical |
|---|---|
| Highly cited | No |