MP32-13 FREQUENCY OF UTILIZATION AND REIMBURSEMENT OF VARIOUS DIAGNOSTIC TESTS AND TREATMENTS FOR TESTICULAR CANCER

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness IV1 Apr 2015MP32-13 FREQUENCY OF UTILIZATION AND REIMBURSEMENT OF VARIOUS DIAGNOSTIC TESTS AND TREATMENTS FOR TESTICULAR CANCER Austin Barber, Mohamed Kamel, Ehab Eltahawy, and Rodney Davis Austin BarberAustin Barber More articles by this author , Mohamed KamelMohamed Kamel More articles by this author , Ehab EltahawyEhab Eltahawy More articles by this author , and Rodney DavisRodney Davis More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1409AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Testicular cancer is uncommon, but the rate has been increasing in the U.S. recently. It is the most prevalent cancer in males between the ages of 20 to 35. Diagnosis & treatment of testicular cancer can be very costly especially to the uninsured. The frequency of utilization & reimbursement of common diagnostic tests & treatment modalities currently used in the management of testicular cancer was assessed. METHODS Life Link™ (IMS health, Danbury, CT) claims database was used. This is the largest & most comprehensive database of integrated medical claims in the U.S. This study identified 877 patients with a primary diagnosis of testicular cancer (ICD 186.9) between 2007 and 2012. All patients had continuous medical insurance 6 months before & 12 months after index diagnosis of testicular cancer. The median reimbursement of claims per patient was calculated. RESULTS A list of the most frequent 200 claims was generated. The most common claim was a vein puncture with median cost of $9.11 (range 0-3,295). Tumor markers alpha fetoprotein & human chorionic gonadotropin were ranked 6th & 7th with a median reimbursement of $52.13(range 0-1,341) & $48.71 (range 0-1,259) respectively. Chest X ray (CXR) & computerized tomography (CT) scan of the chest were ranked 9th & 13th with a median reimbursement of $68.51 (range 0-2,054) & $769 (range 0-7,488) respectively. A contrast CT scan abdomen & pelvis was the 32nd most frequent claim with a median reimbursement of $855.89 (range 0-10,140). The three invasive treatment modalities, chemotherapy (1 hour infusion), radiation therapy & retroperitoneal lymphadenectomy(RPLND) were ranked 8th, 15th & 164th in order of most frequent claimed CPT codes with a median reimbursement of $2,858.38 (range 0-13,721), $3,988.25 (0-12,660) & $2,009.67 (range 187-10,378) respectively. The median reimbursement of additional chemotherapy drugs & chemo infusion >1 hour was $1,368 (range 0-8,538) & $489.47 (range 0-5,292) respectively. Radical orchiectomy was ranked 26th with a median reimbursement of $1,569.20 (range 0-13,559). CONCLUSIONS Testicular cancer is an expensive disease to diagnose & treat. Currently, chemotherapy is more frequently utilized than surgery & radiation in the treatment of testicular cancer in the U.S. despite its high cost. There is a tendency for overuse of chest CT despite the easy availability of the reliable & cheaper CXR. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e369 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Austin Barber More articles by this author Mohamed Kamel More articles by this author Ehab Eltahawy More articles by this author Rodney Davis More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...