Patients paying for colonoscopy prep unnecessarily: Study

Many patients are still paying out of pocket for colonoscopy bowel prep despite a federal law stating it should be covered by insurance, according to a study led by Eric Shah, MD, at Ann Arbor-based University of Michigan.  

The study, published in the American Journal of Gastroenterology, analyzed 2.6 million commercial insurance and Medicare Part D claims between May 2022 and April 2023 to monitor how many patients paid out of pocket for bowel prep medications needed for colonoscopy, according to a July 2 news release from the Colon Cancer Coalition, a nonprofit organization. 

When considering that almost half of patients are cost-shifted toward the use of non-FDA-approved over-the-counter regimens, the data suggests that only 17% of patients pay nothing for their bowel preparation for screening colonoscopy. 

Of the prescription claims analyzed, only 36% had no out-of-pocket costs, according to the release. For Medicare Part D, only 25% of high-volume preps were free. 

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