Journal
JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK
Volume 8, Issue 8, Pages 888-896Publisher
HARBORSIDE PRESS
DOI: 10.6004/jnccn.2010.0066
Keywords
Non-melanoma skin cancer; treatments; care settings; Medicare; costs; basal cell carcinoma; squamous cell carcinoma; BCC; SCC
Categories
Funding
- Galderma
- GlaxoSmithKline/Stiefel Laboratories Inc.
- Astellas
- Abbott Laboratories
- Warner Chilcott
- Centocor, Inc.
- Amgen Inc.
- Photomedex
- Coria/Healthpoint/Valeant
- Pharmaderm/Nycomed
- Dermatology Foundation
- American Society for Dermatologic Surgery
- American Acne Rosacea Society
- National Psoriasis Foundation
- Ortho Pharmaceuticals
- Aventis Pharmaceuticals
- Roche Dermatology
- 3M
- Bristol-Myers Squibb Dermatology
- Novartis Pharmaceuticals Corporation
- Merck Co., Inc.
- Xlibris
- Suncare Research
- Pep lin
- Medscape
- Kikaku
- Caremark
- Informa
- Medical Quality Enhancement Corporation
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Non-melanoma skin cancer (NMSC) is the most common cancer in the United States. Cost of NMSC care primarily depends on 2 factors: care settings and treatment modalities. However, the cost efficacy of NMSC care has been insufficiently addressed in previous literature. Therefore, this article evaluates available research on the cost implications to compare the costs associated with treatment within different care settings and specialties involved, and to assess the costs of different treatment modalities with respect to procedure type, tumor size, and tumor location. This evaluation showed that physician-office settings provided the lowest cost per episode of care ($492) and were the dominant setting for NMSC care; dermatologists managed most NMSC episodes and used a wider range of treatment options than other specialists. Regarding treatment modalities, Mohs micrographic surgery was shown to be similar in cost to traditional surgical excision with permanent sections and was less costly than excision with frozen sections. Electrodessication and curettage and imiquimod were also reported to be inexpensive treatments. Furthermore, a positive correlation was seen between cost and tumor size for any particular treatment modality. Given these comparisons, and the rising incidence of NMSC and potential legislative measures to regulate office-based procedures, it is important to preserve the low-cost management of this disease. (JNCCN 2010;8:888-896)
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