Out-of-Pocket Costs Considerable, Increasing for Prostate Cancer Diagnostic Testing

Jul 16, 2024

MONDAY, July 15, 2024 (HealthDay News) — For patients with private insurance undergoing diagnostic testing after prostate-specific antigen (PSA)-based screening, out-of-pocket costs are considerable and increased from 2010 to 2020, according to a study published online July 15 in Cancer.

Arnav Srivastava, M.D., M.P.H., from the University of Michigan in Ann Arbor, and colleagues identified men aged 55 to 69 years who underwent PSA-based prostate cancer screening from 2010 to 2020. The number of men undergoing follow-up diagnostic testing within 12 months of screening was examined, and men were categorized as biopsy only, magnetic resonance imaging (MRI) only, and MRI + biopsy.

Of the 3,075,841 screened men from 2010 through 2020, 91,850 had a second PSA test and elevated PSA level; of these, 43.9 percent underwent subsequent diagnostic testing. The researchers found that >75 percent of these patients experienced cost-sharing. During the study period, there was a considerable increase in median out-of-pocket costs for patients undergoing biopsy only ($79 to $214), MRI only ($81 to $490), and MRI + biopsy ($353 to $620).

“For some patients, these costs may be significant and stand to deter necessary care following prostate cancer screening,” the authors write. “Consequently, we recommend that policymakers and payers consider prostate cancer screening a multistep process and eliminate cost-sharing for indicated diagnostic testing.”

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