Insurance, Cost, and Patient Advocacy: PSMA PET
The cost of imaging and biopsies can vary widely based on location and insurance, making direct comparisons difficult. However, better use of advanced imaging may help avoid unnecessary biopsies and complications, while patient advocacy plays an important role in improving access and coverage decisions.
Phillip Koo:
There was a question about the cost difference between PSMA PET and biopsies, and that's a really hard question to answer, because the way procedures are reimbursed in the U.S. gets very tricky based on location and whatnot.
In the end, I think avoiding biopsies, avoiding the complications related to biopsies, being more sure when you go in for a biopsy and get a result, I think will lead to overall just downstream cost benefit for the whole healthcare system. But any thoughts you have there as well, Zach?
Zachary Klaassen:
Yeah, no, I think, Phil, I mean, I try… I tell my patients, I only want a biopsy if I really think you have prostate cancer, and so if this helps me make that decision in these patients with sort of these equivocal findings on MRI, that's going to help tremendously. And so, I think, as clinicians, if we can get a tool that will help us make those decisions, that'll be helpful.
To your point, the cost thing is always tricky. I mean, you're talking about different states, different, you know, Medicare versus commercial insurance, whether they're doing the prostate biopsy in the clinic versus the acute surgery center. These are all tricky questions, and they're good questions, they're just hard to answer.
Phillip Koo:
You know, there's a question about insurance companies and whatnot, and I will say that, you know, patients and loved ones and… people have a lot of power here. Power locally, you know, given your U.S. House of Representative members, or your Senate, whoever it might be, your voice speaks volumes.
And, you know, when things like this occur, being able to mobilize and help sort of tell that story and get insurance companies and federal policy and Medicare, can't underestimate the power that patients have in this whole continuum, in this whole process. So, just… I think the fact that you guys are all here listening is one step, and then afterwards, you know, just continue talking about this and getting this into the ears of the right people.
