High medical costs and poor health outcomes in America compared to its global counterparts inspired our healthcare overhaul and the passage of the Affordable Care Act in 2012, and now a significant provision has been added.
According to NBC News, Medicare officials said Thursday that it would pay for lung cancer screens for people at the highest risk of becoming sick. Norman H. Edelman of the American Lung Association called this “an important victory. We’re delighted it has gone through, it’s going to save thousands of lives.”
Part of the delay in approving this provision has been the doubts of some physicians who questioned whether people would benefit from “pricey, computed tomography” scans. However, Medicare officials, the federal health insurance for individuals over 65, believes that the benefits are apparent. Already, many private insurance companies pay for lung cancer screening.
Furthermore, NBC has said experts believe that the screening test, which costs approximately $250-$300, may prevent as many as 20 percent of future deaths from lung cancer. Lung cancer is also the leading cause of cancer deaths in the United States and the third most common cancer diagnosed. Thus, a 20 percent reduction in deaths means a significant number of saved lives. As of now, Medicare has decided to pay for a low-dose CT exam once a year for those 55-77 who have quit smoking in the last 15 years or are current smokers.
Beyond the lives saved, the decision by Medicare might also have a significant impact on the costs incurred by the federal government. As described in an issue of The Journal of Thoracic Oncology, the official journal of the International Association for the Study of Lung Cancer, the average cost per-person for approximately 2 annual screens and the necessary follow-up for those without lung cancer was $453. For those with lung cancer, the costs rose to $2248. For individuals diagnosed with lung cancer, the mean per-person cost for “diagnostic workup, curative intent surgical treatment, and 2 years of follow-up” then rose to $33,344, whereas the costs for those with advanced-stage lung cancer rose to $47,792 because of the need for chemotherapy, radiotherapy and other “supportive care.”
From these statistics, it becomes apparent that early screening in high-risk populations is an excellent mechanism to prevent lung cancer deaths, but it may also save federal dollars. As described by the authors of one of the studies, “If expensive targeted-therapies become widespread in the treatment of advanced, inoperable lung cancer, a screening program could potentially become cost saving while at the same time improving patient outcomes.” Of course decreasing the number of people who need to be screened by educating individuals about the perils of smoking, for example, is the most cost-effective measure; however, this might potentially be an important step toward saving human lives and federal funds.
(Photo courtesy of Morgan)
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