Prostate Cancer Monotherapy Options Lack Pricing Transparency

Recent federal price transparency guidance requires hospitals to provide patients with payer-negotiated costs for more than 300 services; however, recent data shows a lack of transparency for patients with prostate cancer receiving prostate-directed radiation therapy compared to radical prostatectomy.

According to the authors and under current regulations, patients with prostate cancer can only find approximately 10% of payer-negotiated price estimates for external beam radiation therapy (EBRT) and brachytherapy (BT) from the National Cancer Institute-designated cancer centers (NCI-CC) compared to more than 80% of price estimates for radical prostatectomy.

“This represents a potential obstacle to informed decision making, undermines the stated goals of US PT health policy, and the impact on utilization rates (or patient choice of therapy) is unknown,” wrote study authors.

Hospitals are required to provide payer-negotiated prices for ≥300 common services in a “shoppable,” user-friendly, online format under current federal price transparency guidance. Radical prostatectomy (RP) is included in the 70 services, but other treatments are subject to institutional discretion.

“Shoppable” price tools for 58 of 63 (92%) NCI-CC’s offering clinical care were identified by researchers through online query in December 2021. Of these "shoppable" prices EBRT represented 10%, BT was 11%, while RP was 81%. Rates were compared utilizing the chi-squared test (significance level=.05).

Highest rates of reporting “shoppable” prices at 91% came from the 11 Medicare Prospective Payment System with 64% for RP, 27% for EBRT, and 36% for BT.

“Moving forward, mandating the inclusion of common RT services (EBRT and BT) in ‘shoppable’ price tools is a straightforward intervention that may be highly beneficial in this common cancer population,” concluded study authors.

Reference:
Prasad RN, Royce TJ, Wang SJ. Lack of price transparency for prostate-directed radiation therapy relative to radical prostatectomy. J Clin Oncol. 2022;40(suppl 16): abstract 1579. doi:10.1200/jco.2022.40.16_suppl.1579