Doctors have been slow to adopt a recommended short form of radiation therapy for early breast cancer. Data shows it has the potential to save millions of dollars.
Clinicians and patients can be slow to adopt evidence-based approaches to care, despite widespread agreement that unnecessary care can contribute to high healthcare costs.
But cheaper care can be adequate care both in a clinical sense and a financial sense. The slow uptake of evidence-based clinical guidelines and recommendations comes with a price.
Researchers from Duke University Medical Center found huge savings when doctors used a recommended short course of radiation therapy for women with early stage breast cancer.
Still, fewer than half of those eligible for the preferred approach to radiation therapy got it. The researchers estimated that one year of extra care cost $164 million.
The researchers looked at data from the American College of Surgeons cancer database for more than 43,247 breast cancer patients treated in 2011.
Of the patients who were eligible for the shorter course of radiation therapy or no therapy at all, 57% were treated with the longer, costlier regimens. The four-week course of radiation therapy was estimated to cost $8,000, as opposed to the $13,000 traditional six-week regimen.
Numerous studies have shown both treatment approaches to be equally effective.
The costs of treating the national cohort was about $420 million during 2011. Had these patients been treated with the preferred regimen, the bill would have been $256 million. The 39% difference translates to $164 million in savings.
Numerous, large clinical trials have shown that the short course works as well as the long course. That's how it ended up in the guidelines of both Choosing Wisely (contributed by the American Society for Radiation Oncology).
And it is recommended in evidence-based guidelines from the National Comprehensive Cancer Network.
The Duke study's lead author, Rachel Greenup, says the findings reveal that, in this case, quality doesn't have to be sacrificed to reduce costs. "All the stars sort of align in this example," she says. "Women get high quality care at a lower cost and it decreases their treatment burden."
Tinker Ready is a contributing writer at HealthLeaders Media.