Monday, October 30, 2006

Economic Implications of Doggy Radiation Therapy

Kevin, MD posted a rather provocative story regarding radiation therapy (XRT) for pets. It seems that Ipswich Hospital in England wants to capitalize on its underutilized XRT facilities to treat animals -- presumably on a fee-for-service basis. The hospital believes it can capture the equivalent of $95,000 U.S. in revenue per year.

While I can understand that some patient advocates in England are finding the whole idea of sharing medical technology with animals rather distasteful, I personally think it's great. As long as humans aren't obligated to face reduced access because of the new plans, I don't see anything morally wrong with it. In addition, cleanliness routines can easily be adopted that should eliminate any problems in this area as well. And sad to say, there are many pets I know of with more impeccable hygiene standards than some patients I've been in contact with.

What I think is most intriguing about the whole idea are the healthcare finance implications. It will be pretty interesting to see what kind of fee differential there will be for XRT services between humans and pets.

In a way, this is a perfect example of what epidemiologists refer to as an "ecological experiment". Such an experiment is a study that is based on a constellation of fortuitous circumstances in the real world that can be analyzed in such a way as to answer questions of academic importance.

If one wishes to know the impact of third party payers on price in a healthcare system, this is one great model with which to study it. The equipment is the same and one would therefore expect the capital costs to be about the same. The technician salaries are most likely no different. Certainly the record-keeping, privacy provisions and malpractice overhead is higher for humans than for pets but one would think that a rigorous analysis could easily factor those differences out. Likewise, any differences between physician and veterinarian fees can be isolated from the analysis as well.

So it would appear that unless the NHS has started covering pets, the only thing that'll be significantly different will be the lack of a third party payer!

I'm thinking that the calculated price per unit treatment will be less for the pets because the hospital will be limited to charging only what pet owners will be willing to pay out of pocket. For humans there is virtually unlimited demand because someone else will be footing the bill. I for one will be very interested in seeing how the price structure of this little fiscal adventure plays itself out.

Of course my guess presupposes that people care more about their own health than about the health of their pets. This must be considered an unproven assumption!


Anonymous Anonymous said...

I remember doing a double-take once when an in-law used, in all earnestness, the term "our dog's primary physician". Whodathunkit just a few years ago....

October 30, 2006 6:26 PM  
Anonymous Anonymous said...

Why not? The x-ray machines sit idle while human patients wait months just to get in to see the doc, much less get an x-ray.

November 06, 2006 2:23 PM  
Blogger Battlepanda said...

I would worry more about the ethical implication of giving a treatment that might significantly reduce a pet's quality of life.

Unlike humans, dogs live in the present. They don't have much of a concept of mortality. I don't think it's important that important to Fido whether he lives 8 or 13 years, what's more important is that he is happy every day.

Of course, if the effect of the radiation therapy is relatively mild, then I'm all for this plan.

November 10, 2006 12:14 AM  
Blogger Battlepanda said...

(BTW, I have two dogs. Within the last year I've spent hundreds of dollar on their medical care and feed them hideously expensive special kibble that's supposed to keep their livers healthier longer. In that same period of time, I've spent a fraction of that on my own medical care -- just a teeth cleaning, some miscellaneous OTC pills and a pack of dry ginseng slices I nibble now and then.)

November 10, 2006 12:52 AM  
Blogger goesh said...

- may as well, we already treat them as humans, thanks to Disney. We keep pack predators confined in homes and kennels then wonder why they get neurotic and at times vicious, but hey, it's a free country.

November 27, 2006 5:50 AM  
Anonymous Anonymous said...

Let me start by saying this is great blog. i will be back to view it. XRT for doggies is definitely an interesting thought. Howver this experiment already occurs in the US everyday. Most vet hospitals have similar tests a xrays to what humans have. Howver cost is minimal and actually health care delivery is faster and better. There is a grt article in JAMA called tale of two patients. Is a grt read.

December 15, 2006 11:40 AM  

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