Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 17:13:191-200.
doi: 10.2147/CEOR.S295494. eCollection 2021.

Costs of Biopsy and Complications in Patients with Lung Cancer

Yu-Wen Chiu  1 , Yu-Hsiang Kao  1 , Michael J Simoff  2 , David E Ost  3 , Oliver Wagner  4 , James Lavin  4 , Richard A Culbertson  1 , Dean G Smith  1
Affiliations

Costs of Biopsy and Complications in Patients with Lung Cancer

Yu-Wen Chiu et al. Clinicoecon Outcomes Res. .

Abstract

Purpose: To describe the distribution of diagnostic procedures, rates of complications, and total cost of biopsies for patients with lung cancer.

Patients and methods: Observational study using data from IBM Marketscan® Databases for continuously insured adult patients with a primary lung cancer diagnosis and treatment between July 2013 and June 2017. Costs of lung cancer diagnosis covered 6 months prior to index biopsy through treatment. Costs of chest CT scans, biopsy, and post-procedural complications were estimated from total payments. Costs of biopsies incidental to inpatient admissions were estimated by comparable outpatient biopsies.

Results: The database included 22,870 patients who had a total of 37,160 biopsies, of which 16,009 (43.1%) were percutaneous, 14,997 (40.4%) bronchoscopic, 4072 (11.0%) surgical and 2082 (5.6%) mediastinoscopic. Multiple biopsies were performed on 41.9% of patients. The most common complications among patients receiving only one type of biopsy were pneumothorax (1304 patients, 8.4%), bleeding (744 patients, 4.8%) and intubation (400 patients, 2.6%). However, most complications did not require interventions that would add to costs. Median total costs were highest for inpatient surgical biopsies ($29,988) and lowest for outpatient percutaneous biopsies ($1028). Repeat biopsies of the same type increased costs by 40-80%. Complications account for 13% of total costs.

Conclusion: Costs of biopsies to confirm lung cancer diagnosis vary substantially by type of biopsy and setting. Multiple biopsies, inpatient procedures and complications result in higher costs.

Keywords: cancer; diagnosis; economics; frequency.

PubMed Disclaimer

Conflict of interest statement

OW and JL are employees of Intuitive Surgical. YWC, YHK, MJS, DEO, RAC, and DGS received grants for the development of this publication from Intuitive Surgical. MJS is the principal investigator and FDA Medical Expert for the new national multicenter trial of injectable chemotherapeutic and was a consultant for product development for Auris Health. The authors received no honoraria related to the development of this publication. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Lung cancer patient characteristics by biopsy status.
See this image and copyright information in PMC

References

    1. American Cancer Society. Cancer facts & figures. Atlanta, GA; 2018. Available from: https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts.... Accessed December1, 2020.
    1. National Cancer Institute. Surveillance, epidemiology and end results. Available from: https://seer.cancer.gov/statfacts/html/lungb.html. Accessed December1, 2020.
    1. Gould MK, Donington J, Lynch WR, et al. Evaluation of individuals with pulmonary nodules: when is it lung cancer? Diagnosis and management of lung cancer. 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(suppl):e93s–e119s. doi:10.1378/chest.12-2351 - DOI - PMC - PubMed
    1. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Non-Small Cell Lung Cancer Version 2.2019 – November 21; 2018.
    1. Patel JN, Ersek JL, Kim ES. Lung cancer biomarkers, targeted therapies and clinical assays. Transl Lung Cancer Res. 2015;4:503–514. doi:10.3978/j.issn.2218-6751.2015.06.02 - DOI - PMC - PubMed

LinkOut - more resources