A comparative cost analysis of breast reconstruction using acellular dermal matrix (ADM) and traditional tissue expander-/implant-based techniques was carried out. Medicare reimbursement costs were calculated for tissue expander/implant alone (TE/I), TE/I with ADM (TE/I + ADM), and single-stage implant (SSI) with ADM (SSI + ADM). The most expensive procedure at baseline was TE/I + ADM ($11,255.78), followed by TE/I alone ($10,934.18), and SSI + ADM ($5,423.02). Incorporating the probability of complications as derived from the published literature into the cost analysis resulted in an increase in the excess cost of ADM-based procedures (TE/I + ADM, $11,829.02; TE/I, $11,238.60; SSI + ADM, $5,909.83). Although SSI + ADM have the lowest cost, not all patients are suitable candidates for this type of procedure. With increasing focus on healthcare expenditure, it is important that plastic surgeons are aware of the cost implications of using ADM products.
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Received February 4, 2011, and accepted for publication, after revision, February 28, 2011.
Conflicts of interest and sources of funding: Supported by the Peter Jay Sharp Foundation performed with sponsorship (to S.C., A.O.M., A.M.T., B.T.L.)
Reprints: Bernard T. Lee, MD, FACS, Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis St. Suite 5A, Boston, MA 02215. E-mail: firstname.lastname@example.org.