Cost of Nonmelanoma Skin Cancer Treatment in the United States : Dermatologic Surgery

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Cost of Nonmelanoma Skin Cancer Treatment in the United States

CHEN, JOHN G. MD, PhD*,†; FLEISCHER, ALAN B. Jr. MD*; SMITH, EDWARD D. BA*; KANCLER, CYNTHIA MS†; GOLDMAN, NEAL D. MD‡; WILLIFORD, PHILLIP M. MD*; FELDMAN, STEVEN R. MD, PhD*

Author Information

*Bristol-Myers Squibb Center for Dermatology Research, Departments of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina

†Bristol-Myers Squibb Center for Dermatology Research, Departments of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina

‡Bristol-Myers Squibb Center for Dermatology Research, Departments of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, North Carolina

Address correspondence and reprint requests to: Steven R. Feldman, MD, PhD, Wake Forest University School of Medicine, Department of Dermatology, Medical Center Boulevard, Winston-Salem, North Carolina 27157-1071, or e-mail: [email protected].

J.G. Chen, MD, PhD, A.B. Fleischer, Jr., MD, E.D. Smith, BA, C. Kancler, MS, N.D. Goldman, MD, P.M. Williford, MD, and S.R. Feldman, MD, PhD have indicated no significant interest with commercial supporters.

Dermatologic Surgery 27(12):p 1035-1038, December 2001.

Abstract

BACKGROUND 

Despite being the most prevalent form of cancer, the economic impact of nonmelanoma skin cancer (NMSC) in the United States has not been assessed.

OBJECTIVE 

To determine the overall cost and to estimate the cost per episode of NMSC care in the United States in physicians' offices, outpatient surgery centers, and inpatient settings.

METHODS 

Data from the Medicare Current Beneficiary Study 1992–1995 were analyzed to obtain the total cost of NMSC and the cost in different settings. To normalize these data on a per episode basis, the cost in each setting was divided by the number of procedures performed in each setting obtained from the National Hospital Discharge Survey (NHDS, 1992–1997), the National Survey of Ambulatory Surgery (NSAS, 1994–1996), and the National Ambulatory Medical Care Survey (NAMCS, 1995).

RESULTS 

The total cost of NMSC care in the United States in the Medicare population is $426 million/year. Physician office-based procedures for NMSC accounted for the greatest percentage of money spent to treat NMSC and the greatest percentage of procedures. The average cost per episode of NMSC when performed in a physician's office setting was found to be $492. The cost per episode of care in inpatient and outpatient settings were $5537 and $1043, respectively.

CONCLUSION 

Compared to other cancers, the relative magnitude of NMSC treatment costs is currently small because NMSC is managed efficiently and effectively, primarily in office-based settings. Legislative or regulatory measures that discourage office treatment of NMSC will lead to increased cost.

© 2001 by the American Society for Dermatologic Surgery, Inc.

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