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The Payer and Patient Cost Burden of Open Breast Conserving Procedures Following Percutaneous Breast Biopsy

OBJECTIVES: Percutaneous core-needle biopsy (PCNB) is the standard of care to biopsy and diagnose suspicious breast lesions. Dependent on histology, many patients require additional open procedures for definitive diagnosis and excision. This study estimated the payer and patient out-of-pocket (OOP)...

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Autores principales: Kimball, Chloe C, Nichols, Christine I, Vose, Joshua G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989052/
https://www.ncbi.nlm.nih.gov/pubmed/29887731
http://dx.doi.org/10.1177/1178223418777766
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author Kimball, Chloe C
Nichols, Christine I
Vose, Joshua G
author_facet Kimball, Chloe C
Nichols, Christine I
Vose, Joshua G
author_sort Kimball, Chloe C
collection PubMed
description OBJECTIVES: Percutaneous core-needle biopsy (PCNB) is the standard of care to biopsy and diagnose suspicious breast lesions. Dependent on histology, many patients require additional open procedures for definitive diagnosis and excision. This study estimated the payer and patient out-of-pocket (OOP) costs, and complication risk, among those requiring at least 1 open procedure following PCNB. METHODS: This retrospective study used the Truven Commercial database (2009-2014). Women who underwent PCNB, with continuous insurance, and no history of cancer, chemotherapy, radiation, or breast surgery in the prior year were included. Open procedures were defined as open biopsy or lumpectomy. Study follow-up ended at chemotherapy, radiation, mastectomy, or 90 days—whichever occurred first. RESULTS: In total, 143 771 patients (mean age 48) met selection criteria; 85.1% underwent isolated PCNB, 12.4% one open procedure, and 2.5% re-excision. Incidence of complications was significantly lower among those with PCNB alone (9.2%) vs 1 open procedure (15.6%) or re-excision (25.3%, P < .001). Mean incremental commercial payments were US $13 190 greater among patients with 1 open procedure vs PCNB alone (US $17 125 vs US $3935, P < .001), and US $4767 greater with re-excision (US $21 892) relative to 1 procedure. Mean patient OOP cost was US $858 greater for 1 open procedure vs PCNB alone (US $1527 vs US $669), and US $247 greater for re-excision vs 1 procedure. CONCLUSIONS: A meaningful proportion of patients underwent open procedure(s) following PCNB which was associated with increased complication risk and costs to both the payer and the patient. These results suggest a need for technologies to reduce the proportion of cases requiring open surgery and, in some cases, re-excision.
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spelling pubmed-59890522018-06-08 The Payer and Patient Cost Burden of Open Breast Conserving Procedures Following Percutaneous Breast Biopsy Kimball, Chloe C Nichols, Christine I Vose, Joshua G Breast Cancer (Auckl) Original Research OBJECTIVES: Percutaneous core-needle biopsy (PCNB) is the standard of care to biopsy and diagnose suspicious breast lesions. Dependent on histology, many patients require additional open procedures for definitive diagnosis and excision. This study estimated the payer and patient out-of-pocket (OOP) costs, and complication risk, among those requiring at least 1 open procedure following PCNB. METHODS: This retrospective study used the Truven Commercial database (2009-2014). Women who underwent PCNB, with continuous insurance, and no history of cancer, chemotherapy, radiation, or breast surgery in the prior year were included. Open procedures were defined as open biopsy or lumpectomy. Study follow-up ended at chemotherapy, radiation, mastectomy, or 90 days—whichever occurred first. RESULTS: In total, 143 771 patients (mean age 48) met selection criteria; 85.1% underwent isolated PCNB, 12.4% one open procedure, and 2.5% re-excision. Incidence of complications was significantly lower among those with PCNB alone (9.2%) vs 1 open procedure (15.6%) or re-excision (25.3%, P < .001). Mean incremental commercial payments were US $13 190 greater among patients with 1 open procedure vs PCNB alone (US $17 125 vs US $3935, P < .001), and US $4767 greater with re-excision (US $21 892) relative to 1 procedure. Mean patient OOP cost was US $858 greater for 1 open procedure vs PCNB alone (US $1527 vs US $669), and US $247 greater for re-excision vs 1 procedure. CONCLUSIONS: A meaningful proportion of patients underwent open procedure(s) following PCNB which was associated with increased complication risk and costs to both the payer and the patient. These results suggest a need for technologies to reduce the proportion of cases requiring open surgery and, in some cases, re-excision. SAGE Publications 2018-06-04 /pmc/articles/PMC5989052/ /pubmed/29887731 http://dx.doi.org/10.1177/1178223418777766 Text en © The Author(s) 2018 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Kimball, Chloe C
Nichols, Christine I
Vose, Joshua G
The Payer and Patient Cost Burden of Open Breast Conserving Procedures Following Percutaneous Breast Biopsy
title The Payer and Patient Cost Burden of Open Breast Conserving Procedures Following Percutaneous Breast Biopsy
title_full The Payer and Patient Cost Burden of Open Breast Conserving Procedures Following Percutaneous Breast Biopsy
title_fullStr The Payer and Patient Cost Burden of Open Breast Conserving Procedures Following Percutaneous Breast Biopsy
title_full_unstemmed The Payer and Patient Cost Burden of Open Breast Conserving Procedures Following Percutaneous Breast Biopsy
title_short The Payer and Patient Cost Burden of Open Breast Conserving Procedures Following Percutaneous Breast Biopsy
title_sort payer and patient cost burden of open breast conserving procedures following percutaneous breast biopsy
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989052/
https://www.ncbi.nlm.nih.gov/pubmed/29887731
http://dx.doi.org/10.1177/1178223418777766
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