Study finds wide variation in costs of thyroid cancer care

By Zarrin Ahmed

June 4 (UPI) -- There's a wide variation in cost and transparency of payer-negotiated prices for thyroid cancer care, according to a study published Friday in JAMA.

Since the beginning of the year, hospitals in the United States have been required by The Centers for Medicare and Medicaid Services to provide pricing information online about items and services to patients before they receive them.


Researchers from Brigham and Women's Hospital and Massachusetts Eye and Ear used newly available data to analyze price transparency and price variation for the treatment of thyroid cancer.

They found that both varied widely, with only half of the cancer centers reporting disclosure of payer-negotiated prices -- some costs varied as much as 70-fold.

"Reporting payer-negotiated prices is an important first step toward helping patients estimate the cost of care before receiving treatment," study co-author Dr. Roy Xiao said in a press release.

"Based on previous work, we expected to see some degree of variation, but the full range that we saw in our study was certainly surprising," said Xiao, a resident in otolaryngology-head and neck surgery at Brigham and Mass Eye and Ear.

The research team focused on thyroid cancer as a case study, since treatment is known to impose substantial financial burdens on patients. Bankruptcy rates are highest for patients with thyroid cancer, researchers said.


They characterized price availability and variation for thyroid cancer care at 52 National Cancer Institute-designated centers, half of which disclosed commercial payer-negotiated prices.

The researchers found a 70-fold difference in the cost of radioactive iodine treatment and a 44-fold difference in the cost of neck-computed tomography.

Within the centers, costs varied widely depending on the insurer. Procedures like fine needle aspirate biopsy and thyroid uptake scan varied by almost five-fold within centers.

The study's limitations included the fact that physicians practicing at hospitals are often employed by affiliated physician organizations, which may have accounted for why many centers did not report surgeon professional fees for thyroid surgery.

The study was conducted shortly after the implementation of price transparency requirements, the researchers said, noting that disclosure rates and transparency may increase as centers overcome obstacles.

"The introduction of price transparency is a step in the right direction for both patients and clinicians to understand discrepancies in cost," said study senior author Dr. Rosh K.V. Sethi, a head and neck surgeon at Brigham and the Dana-Farber Cancer Institute.

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