Costs of diagnostic and preoperative workup with and without breast MRI in older women with a breast cancer diagnosis

Tracy Onega, Anna N A Tosteson, Julie Weiss, Jennifer Alford-Teaster, Rebecca A. Hubbard, Louise M. Henderson, Karla Kerlikowske, Martha E. Goodrich, Cristina O'Donoghue, Karen J. Wernli, Wendy B. DeMartini, Beth A. Virnig

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Abstract

Background: Breast cancer in the U.S. - estimated at 232,670 incident cases in 2014 - has the highest aggregate economic burden of care relative to other female cancers. Yet, the amount of cost attributed to diagnostic/preoperative work up has not been characterized. We examined the costs of imaging and biopsy among women enrolled in Medicare who did and did not receive diagnostic/preoperative Magnetic Resonance Imaging (MRI). Methods: Using Surveillance, Epidemiology and End Results (SEER)- Medicare data, we compared the per capita costs (PCC) based on amount paid, between diagnosis date and primary surgical treatment for a breast cancer diagnosis (2005-2009) with and without diagnostic/preoperative MRI. We compared the groups with and without MRI using multivariable models, adjusting for woman and tumor characteristics. Results: Of the 53,653 women in the cohort, within the diagnostic/preoperative window, 20 % (N = 10,776) received diagnostic/preoperative MRI. Total unadjusted median costs were almost double for women with MRI vs. without ($2,251 vs. $1,152). Adjusted costs were higher among women receiving MRI, with significant differences in total costs ($1,065), imaging costs ($928), and biopsies costs ($138). Conclusion: Costs of diagnostic/preoperative workups among women with MRI are higher than those without. Using these cost estimates in comparative effectiveness models should be considered when assessing the benefits and harms of diagnostic/preoperative MRI.

Original languageEnglish (US)
Article number76
JournalBMC Health Services Research
Volume16
Issue number1
DOIs
StatePublished - Jan 1 2016

Keywords

  • Beast cancer
  • Breast MRI
  • Cost of breast MRI
  • Diagnostic/preoperative breast MRI

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    Onega, T., Tosteson, A. N. A., Weiss, J., Alford-Teaster, J., Hubbard, R. A., Henderson, L. M., Kerlikowske, K., Goodrich, M. E., O'Donoghue, C., Wernli, K. J., DeMartini, W. B., & Virnig, B. A. (2016). Costs of diagnostic and preoperative workup with and without breast MRI in older women with a breast cancer diagnosis. BMC Health Services Research, 16(1), [76]. https://doi.org/10.1186/s12913-016-1317-6