Medicare cost of colorectal cancer screening: CT colonography vs. optical colonoscopy.
OBJECTIVE
To compare the Medicare population cost of colorectal cancer (CRC) screening of average risk individuals by CT colonography (CTC) vs. optical colonoscopy (OC).


METHODS
The authors used Medicare claims data, fee schedules, established protocols, and other sources to estimate CTC and OC per-screen costs, including the costs of OC referrals for a subset of CTC patients. They then modeled and compared the Medicare costs of patients who complied with CTC and OC screening recommendations and tested alternative scenarios.


RESULTS
CTC is 29% less expensive than OC for the Medicare population in the base scenario. Although the CTC cost advantage is increased or reduced under alternative scenarios, it is always positive.


CONCLUSIONS
CTC is a cost-effective CRC screening option for the Medicare population and will likely reduce Medicare expenditures for CRC screening.
Milliman, One Pennsylvania Plaza, 38th Floor, New York, NY, 10019, USA. bruce.pyenson@milliman.com.
Bruce
B
Pyenson
University of Wisconsin School of Medicine & Public Health, Madison, WI, USA.
Perry J
PJ
Pickhardt
Milliman, One Pennsylvania Plaza, 38th Floor, New York, NY, 10019, USA.
Tia Goss
TG
Sawhney
Milliman, One Pennsylvania Plaza, 38th Floor, New York, NY, 10019, USA.
Michele
M
Berrios
D000368:Aged; D023881:Colonography, Computed Tomographic / Q000191:economics*; D003113:Colonoscopy / Q000191:economics*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000191:economics*; D003362:Cost-Benefit Analysis / Q000191:economics*; D055088:Early Detection of Cancer / Q000191:economics / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods; D006278:Medicare / Q000191:economics*; D014481:United States
CT colonography; Cost-effectiveness; Costs; Medicare; Optical colonoscopy