A study published in the Journal of the American College of Radiology on January 28 is the first to assess the potential clinical benefits, associated expenditures, and net budget impact of digital breast tomosynthesis (DBT) among women enrolled in Medicaid. These new data focus specifically on the clinical-economic value of DBT for breast cancer screening for Medicaid enrollees.
“We found that using DBT as a mammography screening modality by Medicaid enrollees could substantially reduce the need for follow-up diagnostic services and improve detection of invasive cancers,” said Dr. Laurie L. Fajardo, an author of the study and professor of Radiology and Imaging Sciences at the University of Utah School of Medicine. “Our study shows that the clinical benefits of DBT translate into potentially meaningful cost savings for Medicaid.”
Using Medicaid claims data and other clinical data, the study’s economic model predicts an annual cost savings from DBT of $8.14 per patient. Approximately 18,500 women with Medicaid are screened each year in Oregon, representing a potential savings of approximately $150,000 per year.
The study authors evaluated two screening mammography scenarios with an economic model that focused on two main drivers of DBT value: 1) capacity for DBT to reduce the number of women recalled for additional follow-up imaging and diagnostic services; and 2) capacity of DBT to facilitate earlier diagnosis of cancer at a time when treatment costs are lower.
“Breast cancer screening historically has occurred at much lower rates for women enrolled in Medicaid and women with Medicaid are more likely to experience delays in breast cancer follow-up treatment,” noted Dr. Fajardo. “Wider adoption of DBT for routine breast cancer screening among Medicaid enrollees presents an opportunity to address disparities and barriers to accessing value-based preventive care by some of Oregon’s most vulnerable citizens.”
The study is available online at http://www.jacr.org/article/S1546-1440(16)31328-X/abstract.
