Insurance affects breast cancer therapy

Published: April 29, 2011 at 2:12 AM

HOUSTON, April 29 (UPI) -- Breast cancer therapy is affected by where a woman lives and whether certain treatment is included in Medicare reimbursement, U.S. researchers say.

Dr. Benjamin D. Smith of the M.D. Anderson Cancer Center in Houston and colleagues used Medicare data for 26,163 women with localized breast cancer who had undergone surgery and radiation therapy from 2001 to 2005.

Smith says they focused on intensity-modulated radiation therapy -- a radiation delivery technique that modulates the radiation to maximize the dose of radiation to the tumor while minimizing the dose to adjacent normal tissues, reducing radiation side effects.

The study, published in the Journal of the National Cancer Institute, found that billing for intensity-modulated radiation therapy in regions of the country where local Medicare carriers covered intensity-modulated radiation, was more than five times higher than in regions where it was not covered.

The average cost of radiation within the first year of diagnosis was $7,179 without intensity-modulated radiation therapy and $15,230 with intensity-modulated radiation therapy, Smith says.

The study authors conclude the data "suggest that with respect to breast radiation therapy, much of the variation in cost can be directly attributed to inconsistent treatment definitions and reimbursement rates authorized by Medicare and its intermediaries."

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