Men would be willing to pay up to $2,000 of their own money to get a more accurate test to detect — or rule out — prostate cancer.
This was the outcome of a study that examined how men viewed a technique that — although available — is rarely covered by health insurance plans.
The research, “Examining patient’s willingness-to-pay for MRI guided prostate biopsy: Implications in the era of health savings accounts,” was published in the journal Urology Practice. It was a collaborative effort of Loyola Medicine and Loyola University Chicago’s Quinlan School of Business and Stritch School of Medicine.
MR-US prostate biopsy is the name of the pricey method. It combines advanced imaging with a traditional prostate biopsy.
Physicians first do a magnetic resonance imaging (MRI) scan of the prostate. The images are fused with ultrasound images to create a three-dimensional view of the prostate. A physician uses the 3D view doing a biopsy to guide a biopsy needle to suspicious-looking lesions.
A standard biopsy involves a physician taking 12 samples across the prostate. If a tumor is not in the areas, it’s likely to be missed.
Although the imaging-biopsy combo procedure is more accurate, it is not always covered by insurance. And it costs between $700 and $1,570 more than a standard biopsy, depending on the clinic.
To understand how men view the combo technique, and what they would be willing to pay for it, a research team surveyed 202 men at a urology clinic.
They asked the men to imagine that they needed a prostate cancer biopsy, and had $2,000 in a health savings account.
In the United States, people with high-deductible insurance plans can open such an account. It works like a normal savings account, but savings are tax-deductible. And the money can be spent only on healthcare.
The men said they were prepared to pay $1,598 more for a biopsy that increased from 43 percent to 51 percent the likelihood that doctors would detect a prostate cancer. The figures mirror the difference doctors see between standard and MR-US biopsies.
If a biopsy could increase from 70% to 90% the chance of ruling out cancer when none is there, the men would pay $2,034. Again, the difference reflects that seen between the two biopsy types.
In contrast, the men were not prepared to pay extra for a biopsy that would increase the chance of detecting only high-risk cancer.
“An enhanced understanding of patient preferences, and the monetary value that they place on these preferences, will be imperative to understand as healthcare delivery rapidly moves towards a consumer-driven era,” the researchers said in a press release.
Since health savings accounts are becoming more common, the findings may be useful when urologists discuss options with their patients.
“The value placed on MR-US prostate biopsy is particularly useful when urologists are counseling patients with a health savings account and/or patients whose insurance does not cover MR-US prostate biopsy,” researchers wrote.
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