Tuesday, November 7, 2017

BRCA Math 2018 at 25,000 Utilization











Based on CY2016 utilization (about 25,000) and CY2018 PAMA predicted prices per CPT code.

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Ad Hoc numbers, if of interest:

Based on ad hoc numbers, there are about 20M women in Medicare FFS, and if there are 25,000 BRCA tests, that is 1 per 1000 Medicare women. 

There are about 250,000 new cases of breast cancer in the US per year.   Let's just guess that 1/2 are Medicare age, or about 100,000.   If Medicare does 25,000 BRCA tests, and only on Medicare women with breast cancer, that would be 1 per 4 Medicare women with new breast cancer. 

These are purely back of envelope numbers; better data is probably available but these would be in rough ballparks. 

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