Patient out-of-pocket costs for suspicious pulmonary nodule biopsy in lung cancer patients

Abstract

Aims: Dynamic changes in the payer landscape have resulted in increasing out-of-pocket costs (OOPC). Little is known about OOPC for patients undergoing biopsy for suspicious pulmonary nodules in the U.S. This study seeks to describe the spectrum of OOPC for diagnostic tissue sampling for suspicious pulmonary nodule with an ultimate diagnosis of lung cancer.Methods: Retrospective cohort study of adult patients with a primary lung cancer diagnosis and treatment who underwent diagnostic biopsy for suspicious pulmonary nodule utilizing IBM Marketscan ® Databases (2013 to 2017). Claims data included both total hospital and physician billed costs, insurer reimbursement and OOPC. Out-of-pocket costs were further stratified by type of biopsy, whether the patient underwent a single or multiple biopsies, and year of biopsy.Results: A total of 22,870 patients age 18-95 who underwent diagnostic lung biopsy were identified. The gender ratio was 49 to 51 for female;male, and 50% of patients were aged 65 or above. 78% of patients had a co-morbidity. The median OOPC for a patient receiving a single biopsy (any type

Identification of an oncological clinical pathway through questionnaires to health professionals

“…Given that the Portuguese healthcare system consists of both public and private sectors, our study found that PHCs participants indicated diagnostic pathways for cancer patients linked to private institutions, which would imply out-of-pocket expenses for patients. These types of expenses have been thoroughly studied for treatments or medical care and until recent years no studies concerning out-of-pocket diagnostic were published [ 48 ]. Patients typically incur costs for laboratory and diagnostic services, with additional expenses for biopsies and complications [ 49 – 51 ].…”