MP17-04 IMPACT OF TISSUE-BASED GENOMIC TESTING ON PAYMENTS FOR PROSTATE CANCER CARE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP17-04 IMPACT OF TISSUE-BASED GENOMIC TESTING ON PAYMENTS FOR PROSTATE CANCER CARE Benjamin Croll, Dattatraya Patil, Sagar Patel, and Christopher Filson Benjamin CrollBenjamin Croll More articles by this author , Dattatraya PatilDattatraya Patil More articles by this author , Sagar PatelSagar Patel More articles by this author , and Christopher FilsonChristopher Filson More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003237.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Tissue-based genomic biomarkers have been approved for use in risk-stratification of prostate cancer for more than a decade. Prior cost analyses relied on simulation modeling of artificial cohorts, and there has been limited research on real-world expenditures. We assessed 12-month post-biopsy healthcare payments to compare payer expenditures for prostate cancer patients who did and did not receive post-biopsy tissue-based genomic testing. METHODS: We used IBM MarketScan Commercial Claims and Medicare Supplemental data to identify newly-diagnosed patients (2018–2019). Inflation-adjusted total healthcare payments were calculated in the 12-month period following diagnostic biopsy. Outliers with the top and bottom 2.5% percentile of total payments were excluded. Multivariable linear regression was conducted to estimate the effect of receiving genomic testing (Oncotype DX, Prolaris, and Decipher) on payments, after controlling for treatment modality, insurance status, and other demographic information. We stratified our analysis based on treatment received. RESULTS: We identified 10,859 patients in our cohort (9,242 privately-insured; 1,617 Medicare eligible). Among this group, 24% received radiation therapy (RT), 44% had radical prostatectomy (RP), and 33% had no identified treatment (AS/WW/NT). Genomic testing was more common in 2019 than 2018 (6.9% vs. 3.5%, p<.001) and was more common in the AS/WW/NT group (8.3%) than those treated with RT (3.4%) or RP (3.9%), p<.001. Median payments for each genomic test ranged from $2,156-3,873. Prediction modeling based on multivariable analysis demonstrated that genomic testing is associated with payment differences ranging from -$119 to +$494 in individual treatment groups (Figure 1). CONCLUSIONS: Use of tissue-based genomic testing is associated with significant expense. Despite this expense, their use was associated with similar total payments across treatment groups, with the greatest savings ($119) in Medicare patients receiving RT and the greatest expense in Medicare patients undergoing RP ($494). Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e213 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benjamin Croll More articles by this author Dattatraya Patil More articles by this author Sagar Patel More articles by this author Christopher Filson More articles by this author Expand All Advertisement PDF downloadLoading ...