Chad Tang, MD

Understanding Access and Costs for Prostate Cancer Care
 

Chad Tang, MD, along with Benjamin Smith, MD, and Grace Smith, MD, PhD, MPH, at the University of Texas MD Anderson Cancer Center conducted an analysis to understand the barriers to access and costs associated with treatment options for patients with prostate cancer including, surgery, IMRT, SBRT, brachytherapy, proton therapy and active surveillance. Prostate cancer is the most common cancer among men in the U.S., but many patients are not presented with the full array of radiation treatment options due to complex factors, including referral, reimbursement, training and the limited number of radiation oncologists, especially those practicing brachytherapy. Dr. Tang’s study was the first national-level analysis of the costs, financial toxicity and utilization of these treatment options, and the results could be used to help increase access to radiation therapy for patients with prostate cancer across the U.S.

In the study, Dr. Tang’s team:

• Assessed national trends in the number and location of providers who routinely offer each of the prostate cancer treatment options. From this data, they created a map of the U.S. that shows the relative utilization of each treatment with a focus on where prostate cancer patients’ options are limited.
• Compared patient and payer costs for the treatment options, including those directly associated with treatment, the total costs over a six-month window starting with diagnosis, and the costs incurred after the treatment was completed.
• Conducted a prospective survey of patients treated with surgery and brachytherapy at their institution to evaluate financial toxicity.

Data from the MarketScan and Medicare databases was used, which provided a balanced view across private and public health insurance in both young and old prostate cancer patients nationwide. Future plans include the development of a larger prospective observational study on the financial burden of the different treatment options available to prostate cancer patients. 

Publications

 

• Influence of Geography on Prostate Cancer Treatment was published online in the International Journal of Radiation Oncology, Biology, Physics on December 11, 2020. 
• Costs and Complications After a Diagnosis of Prostate Cancer Treated With Time-Efficient Modalities: An Analysis of National Medicare Data was published in the July 1, 2020 issue of Practical Radiation Oncology.