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Fractionation scheme and treatment planning method for early glottic cancer in the United States: Economic impact of different medical decisions
Author(s) -
Moore Assaf,
Den Robert B.,
Popovtzer Aaron,
Goldvaser Hadar,
Gordon Noa,
Goldstein Daniel A.
Publication year - 2020
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26082
Subject(s) - reimbursement , medicine , radiation therapy , population , economic impact analysis , dose fractionation , health care , environmental health , surgery , economic growth , economics , microeconomics
Background Early glottic cancers are often treated with radiotherapy (RT). We assessed the economic impact of fractionation scheme and planning method for payers in the United States. Methods A population‐based analysis of the total cost of RT for early glottic cancers in the United States was performed annually. The target population was calculated using the Surveillance, Epidemiology, and End Results database. RT costs were based on 2019 pricing by Medicare. Results We estimate that 3794 patients with early glottic cancers are treated with RT annually. The cost of RT per patient ranges between US $13 964 and $26 599 by fractionation and planning method. Hypofractionation reduces costs by 9% to 14%, while Intensity‐modulated radiotherapy (IMRT) increases costs by 65% to 72%. IMRT‐based standard fractionation leads to an excess cost of $47 937 076 compared with 3D‐based hypofractionation. Conclusions 3D‐based hypofractionated RT is the current standard of care. It would be reasonable for public and private payers to consider evidence‐based policies for radiation reimbursement.