Cost Differences After Initial CT Colonography Versus Optical Colonoscopy in the Elderly

In Academic Radiology, Hanna Zafar and colleagues, including Peter Groeneveld, compare differences in total Medicare costs among asymptomatic elderly patients in the year after initial computed tomographic colonography (CTC) or initial optical colonoscopy (OC). In 2009, the Centers for Medicare and Medicaid Services stopped covering CTC screening among asymptomatic individuals based on the scarcity of data regarding differences in outcomes and costs between patients who received CTC and OC. Zafar and colleagues performed a retrospective cohort study of asymptomatic Medicare enrollees who received initial CTC or OC between January 2007 and December 2008. The researchers find higher adjusted costs of outpatient testing among patients after initial CTC as compared to OC, potentially related to colonic and extracolonic follow-up. However, they do not find differences in adjusted total, inpatient, or outpatient costs between these two cohorts. From the downstream cost perspective, these findings suggest CTC and OC are equivalent.