Interventional radiologists provide patients with primary and secondary liver cancer with high-quality, high-impact care in a more cost-efficient way than other specialties, according to a retrospective study published in the Journal of Vascular and Interventional Radiology (JVIR).
The study, funded by the Society of Interventional Radiology (SIR), reviewed Medicare data from 2016–2021 covering approximately 110,000 patients per year. The investigators, led by SIR secretary Nishita Kothary (Stanford University School of Medicine, Palo Alto, USA) found that interventional radiologists treated nearly 51% of Medicare patients with liver cancer, with the volume increasing over time as routine oncologic care increasingly relies on interventional radiology (IR) for essential support services (such as image-guided biopsy, venous access and drainage) and for therapeutic solutions, such as percutaneous ablation and transarterial therapies.
“Liver cancer demands complex, multidisciplinary care and interventional radiologists have a central and transformative role to play on this care team,” said Kothary. “Interventional oncologists harness minimally invasive, image-guided techniques to deliver targeted therapies that can be curative, adjunct to systemic therapies, or even serve as a bridge to organ transplantation,” he added. “These therapies can have fewer side-effects than systemic therapies and a faster recovery time, making the treatment less onerous on the patient’s quality of life.”
Physician payments and patient out-of-pocket costs rose dramatically during the study period, with oncology accounting for the steepest increases (72% over the five-year period). However, the overall cost burden of IR to the healthcare system was comparably lower. IR accounted for 7.4% of total payments while performing 11.7% of the Work Relative Value Units (wRVUs), a standard, Medicare-derived metric used to measure the time, skill, and intensity a physician invests in a patient service. By comparison, oncologists accounted for 52.5% of total payments while performing 13.7% of wRVUs, and radiation oncologists accounted for 5.4% of payments while performing 4.5% of wRVUs.
“IR delivers the same quality of care at a fraction of the cost of oncologists, which is potentially more valuable to patients, payors and healthcare systems, especially when you consider the fact that recovery times are faster and hospital stays are often not required following an IR treatment,” said SIR treasurer C Matthew Hawkins, an interventional radiologist and professor at the Emory University School of Medicine in Atlanta, USA. He is co-author on the paper. “As payors and regulators push for more cost-effective care, the urgency for interventional radiologists to be present at the table in discussions of cancer care policy, cost and resource allocation only grows.”
“IR can offer cost-efficient care for hepatobiliary disease with comparable or improved clinical efficacy as compared to alternative treatment options offered by other specialties,” Hawkins said. “Interventional radiologists must be a part of the discussion, especially as we move to a system of alternative payment models to control costs of care.”
