Will your employees soon be asking for 3-D Mammography? Should you cover it?
A Quick Review of 3-D Mammography
Tomosynthesis, also known as 3-D mammography, is a more advanced form of mammography than the digital mammography that is currently available to most patients. Experts say 3-D mammography has these advantages:
- It is better at detecting cancer earlier in the process.
- It does a better job detecting cancer in patients with dense breast tissue.
- It is less likely to require that patients return to the doctor’s office for follow-up screening.
On the negative side, 3-D mammography delivers a higher dose of radiation to the patient when compared to traditional mammography alone. The more radiation you are exposed to over time, the more your lifetime risk of cancer increases.
Cost-Effectiveness of 3-D Mammography
Studies are now exploring whether 3-D Mammography is cost-effective. One of the early studies on this topic was covered in the Modern Healthcare blog in January 2015. The blog article refers to a study that appeared in the Journal of ClinicoEconomics and Outcomes Research. The article noted that while 3-D mammography costs more than standard mammography alone, it may prove cost-effective over time because fewer callbacks for repeat mammograms or additional testing are required. Based on a comparison of 3-D mammography with standard mammography alone, the study estimated savings at $28 per patient.
While 3-D Mammography identifies more cancers earlier in the process, it is impossible to know at this time whether 3-D Mammography is finding the kinds of cancers that require treatment. Some slow-growing cancers do not require treatment, and treating them can sometimes cause more harm than good. However, when doctors cannot identify whether a cancer requires treatment or not, they typically opt to provide treatment to protect the patient. We may not know whether 3-D mammograms are improving long-term outcomes for patients until we know more about the kinds of cancers that are detected and treated.
At this time, data is unavailable to show the long-term impact of 3-D mammography on treatment costs.
More consumers may request 3-D mammography as articles about its benefits appear in the media and hospital advertisements.
The Modern Healthcare article notes that from the perspective of a consumer with a high-deductible health plan, having fewer callbacks can be desirable because the screening mammogram must be fully covered by the health plan, while any additional, diagnostic mammography is covered under the standard health plan, including requirements for deductibles and co-payments that are likely to increase the patient’s out-of-pocket costs. This could also help fuel consumer demand for 3-D mammography.