Cost-Sharing and Out-of-Pocket Cost for Women Who Received MRI for Breast Cancer Screening.
Journal
Journal of the National Cancer Institute
ISSN: 1460-2105
Titre abrégé: J Natl Cancer Inst
Pays: United States
ID NLM: 7503089
Informations de publication
Date de publication:
07 02 2022
07 02 2022
Historique:
received:
27
12
2020
revised:
17
05
2021
accepted:
26
07
2021
pubmed:
29
7
2021
medline:
22
3
2022
entrez:
28
7
2021
Statut:
ppublish
Résumé
The financial protection of the prevention provision of the Affordable Care Act (ACA) doesn't apply to breast MRI but only to mammography for breast cancer screening. The purpose of the study is to examine the financial burden among women who received breast magnetic resonance imaging (MRI) for screening. This observational study used the Marketscan database. Women who underwent breast MRI between 2009 and 2017 and had screening mammography within 6 months of the MRI were included. We compared the time trend of the proportion of zero cost-share for women undergoing screening mammography and that for MRI. We quantified out-of-pocket (OOP) costs as the sum of copayment, coinsurance, and deductible and defined zero cost-share as having no OOP cost. We conducted multivariable logistic regression and 2-part model to examine factors associated with zero cost-share and OOP costs of MRI, respectively. During the study period, 16 341 women had a screening breast MRI. The proportion of screening MRI claims with zero cost-share decreased from 43.1% (2009) to 26.2% (2017). The adjusted mean OOP cost for women in high-deductible plans was more than twice the cost for their counterparts ($549 vs $251; 2-sided P < .001). Women who resided in the South in the post-Affordable Care Act era were less likely to have zero cost-share and paid higher OOP costs for screening MRI. Many women are subject to high financial burden when receiving MRI for breast cancer screening. Those enrolled in high-deductible plans and who reside in the South are especially vulnerable financially.
Sections du résumé
BACKGROUND
The financial protection of the prevention provision of the Affordable Care Act (ACA) doesn't apply to breast MRI but only to mammography for breast cancer screening. The purpose of the study is to examine the financial burden among women who received breast magnetic resonance imaging (MRI) for screening.
METHODS
This observational study used the Marketscan database. Women who underwent breast MRI between 2009 and 2017 and had screening mammography within 6 months of the MRI were included. We compared the time trend of the proportion of zero cost-share for women undergoing screening mammography and that for MRI. We quantified out-of-pocket (OOP) costs as the sum of copayment, coinsurance, and deductible and defined zero cost-share as having no OOP cost. We conducted multivariable logistic regression and 2-part model to examine factors associated with zero cost-share and OOP costs of MRI, respectively.
RESULTS
During the study period, 16 341 women had a screening breast MRI. The proportion of screening MRI claims with zero cost-share decreased from 43.1% (2009) to 26.2% (2017). The adjusted mean OOP cost for women in high-deductible plans was more than twice the cost for their counterparts ($549 vs $251; 2-sided P < .001). Women who resided in the South in the post-Affordable Care Act era were less likely to have zero cost-share and paid higher OOP costs for screening MRI.
CONCLUSIONS
Many women are subject to high financial burden when receiving MRI for breast cancer screening. Those enrolled in high-deductible plans and who reside in the South are especially vulnerable financially.
Identifiants
pubmed: 34320199
pii: 6329641
doi: 10.1093/jnci/djab150
pmc: PMC8826560
doi:
Types de publication
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
254-262Subventions
Organisme : NCI NIH HHS
ID : P30 CA016672
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA207216
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
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