Although the US Centers for Medicare & Medicaid Services has instituted a price transparency mandate requiring hospitals to put their chargemasters in the public sphere, this mandate may be insufficient to allow patients to estimate or compare prices for prostate cancer radiation treatment, according to the results of a recent study.

The stated goal of the mandate was to encourage “consumer friendly communication” to help potential patients understand their financial liability at different hospitals.

The researchers looked at the February 2019 publicly available price-containing chargemasters for National Cancer Institute-designated cancer centers. Specifically, they analyzed the charge per fraction of intensity-modulated radiation therapy used in standard prostate cancer radiation treatment. Based on this price per fraction, they calculated the price of a 28-fraction course of radiation at all of the 63 included hospitals.

They found a high degree of price variations. Of the included hospitals, only 84% included a price for simple intensity-modulated radiation therapy. Of the 52 hospitals with a price available, the charges for a 28-fraction course ranged from $18,368 to $399,056. This was a 21.7-fold price difference between the least and most expensive hospital.


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The mean price was $111,728.80 — and this price, the researchers noted, is 10.1 times the price paid by Medicare, “making it unlikely that the price information is reliable enough to facilitate comparison shopping or drive price competition.”

“Price transparency has the potential to drive value-based decision-making and decrease the financial toxicity of cancer care; however, this analysis demonstrates the potential perils and shortcomings of recent price transparency policy,” the researchers wrote.

Reference

Agarwal A, Dayal A, Kircher SM, et al. Analysis of price transparency via National Cancer Institute-Designated Cancer Centers’ chargemasters for prostate cancer radiation therapy [published online January 16, 2020]. JAMA Oncol. doi: 10.1001/jamaoncol.2019.5690