Pre-Colonoscopy Consults Are Just Too Expensive

Visits to the gastroenterologist for pre-colonoscopy consultations could add to a slew of unnecessarily expensive procedural costs.

While the pricey procedural visits have long been condemned, their actual long-term impact has yet to be closely assessed.

Kevin R. Riggs, MD, MPH, instructor in medicine at Johns Hopkins University, Baltimore, MD, and colleagues analyzed the use and expenditure data of 842,849 individuals 50-64 years who underwent colonoscopies between 2010 and 2013 with employer-sponsored private health insurance.

The team hoped to understand the proportion of colonoscopies for colon cancer screening and polyp surveillance completed prior to office visits and the associated payments for those visits.

According to Riggs, “Widely accepted guidelines for colon cancer screening and polyp surveillance and the generally low risk of colonoscopy might obviate the need for many of these visits. Open-access endoscopy, which allows patients to be referred for endoscopies without a prior gastroenterology office visit, began in the US in the 1990s, though recent estimates of the prevalence of the practice are lacking.”

Results showed 29.4% of the group has a pre-colonoscopy office visit and of those who completed pre-colonoscopy visits, 77.4% were linked to diagnosis of screening or preoperative evaluation.

What does this mean?

The average of the pre-colonoscopy visits cost $123.83, and when circulated across all patients. This visit would add an average cost of $36.37 for each office visit.

“Although the pre-colonoscopy office visits added a modest $36 per colonoscopy in this population, there are an estimated 7 million screening colonoscopies performed in the US annually. So this cumulative costs are significant,” commented Riggs.