Traditional versus streamlined management of basal cell carcinoma (BCC): A cost analysis - 15/10/15
Abstract |
Background |
Facing rising incidence of basal cell carcinoma (BCC) and increasing pressure to contain health care spending, physicians need to contemplate cost-effective paradigms for managing BCC.
Objective |
We sought to perform a cost analysis comparing the traditional BCC management scheme with a simplified detect-and-treat scheme that eliminates the biopsy before initiating definitive treatment.
Methods |
A decision analytic model was developed to compare the costs of traditional BCC management with the detect-and-treat scheme, under which qualifying lesions diagnosed clinically were either treated with shave removal or referred to Mohs micrographic surgery for on-site histologic check. Values for model parameters were based on literature and our institutional data analysis. Costs were based on 2014 Medicare fee schedule.
Results |
The average cost per lesion with detect-and-treat scheme was $449 for non-Mohs micrographic surgery–indicated lesions (vs $566 with traditional management, $117 in savings) and $819 for Mohs micrographic surgery–indicated lesions (vs $864 with traditional management, $45 in savings). The combined weighted average savings per case was $95 (15% of total average cost). Conclusions were similar under various plausible scenarios.
Limitations |
Model parameter values may vary based on individual practices.
Conclusions |
A simplified management strategy eliminating routine pretreatment biopsy can reduce BCC treatment cost without compromising quality of care.
Le texte complet de cet article est disponible en PDF.Key words : basal cell carcinoma, chemocheck, cost analysis, decision analysis model, detect-and-treat scheme, shave removal
Abbreviations used : BCC, DAT, MMS
Plan
Funding sources: None. |
|
Conflicts of interest: None declared. |
Vol 73 - N° 5
P. 791-798 - novembre 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?