Department of Radiation Oncology, University of Kansas Cancer Center, Kansas City, Kansas.
Department of Radiation Oncology, University Hospitals, Case Western Reserve University, Cleveland, Ohio.
Pract Radiat Oncol. 2022 Nov-Dec;12(6):e481-e485. doi: 10.1016/j.prro.2022.04.003. Epub 2022 Apr 18.
Financial toxicity is increasingly identified as an important issue in cancer care. Limited data are available on direct out of pocket (OOP) costs for radiation therapy, which are important for providers and patients.
Retrospective analysis of 247 consecutive patients with nonmetastatic breast and prostate cancer treated with curative intent. Data were collected on demographics, treatments received and insurance plan specifications, including annual OOP maximum, deductibles, co-insurance rates, OOP already paid prior to starting radiation therapy, and actual estimated OOP for radiation therapy. Multivariable logistic regression was used to examine associations between insurance factors, radiation technique, concurrent systemic therapy, and month of treatment with a patient reaching OOP maximum with radiation treatment.
In the study, 137 and 110 patients with breast and prostate cancer were evaluated. Mean plan specified annual OOP maximum for commercial and Medicare Advantage plans were $4064 and $4661, respectively; 100% of commercially insured patients and 54.7% Medicare Advantage patients reached their OOP maximum with radiation therapy. Annual OOP maximum for Medicare plus supplement, Medicaid, and Tricare were minimal. On multivariable analysis, concurrent systemic therapy (odds ratio 6.20, P = .03) was associated with patient reaching OOP maximum, but radiation technique was not.
Out of pocket cost for radiation therapy services may be reasonably estimated based on insurance type and structure. Medicare plus supplement and Medicaid plans have negligible OOP, while all patients with commercial plans reached annual OOP maximums. This study provides practical information to help providers to better counsel patients.
财务毒性日益被认为是癌症治疗中的一个重要问题。关于放射治疗的直接自付费用（OOP）的数据有限，这对提供者和患者都很重要。
对 247 例接受根治性治疗的非转移性乳腺癌和前列腺癌连续患者进行回顾性分析。收集了人口统计学、治疗方法和保险计划规格的数据，包括年度 OOP 最高限额、免赔额、共同保险费率、开始放射治疗前已支付的 OOP 以及放射治疗的实际估计 OOP。多变量逻辑回归用于检查保险因素、放射技术、同期全身治疗以及治疗月份与患者达到放射治疗 OOP 最高限额之间的关联。
在这项研究中，评估了 137 例乳腺癌和 110 例前列腺癌患者。商业和 Medicare Advantage 计划规定的年度 OOP 最高限额分别为 4064 美元和 4661 美元；100%的商业保险患者和 54.7%的 Medicare Advantage 患者在接受放射治疗时达到了 OOP 最高限额。医疗保险加补充、医疗补助和 Tricare 的年度 OOP 最高限额最低。多变量分析显示，同期全身治疗（优势比 6.20，P = 0.03）与患者达到 OOP 最高限额相关，但放射技术无关。
根据保险类型和结构，放射治疗服务的自付费用可以合理估计。医疗保险加补充和医疗补助计划的 OOP 可忽略不计，而所有商业计划的患者都达到了年度 OOP 最高限额。本研究为帮助提供者更好地为患者提供咨询提供了实用信息。
