Cost efficacy of wide local excision of pT1a melanoma in office versus operating room settings

A Cost Comparison Between Mohs Micrographic Surgery and Conventional Excision for the Treatment of Head and Neck Melanomas In Situ and Thin Melanomas

“…MMS and CE-Office demonstrated lower costs than CE-OR in the institutional (MMS $2092.95, CE-Office $1376.45, CE-OR $2856.87) and insurance claims (MMS $2882.25, CE-Office $2043.98, CE-OR $5122.19) cohorts, which upholds previous findings describing the lower cost of outpatient surgery for melanoma 13 and nonmelanoma 17–19 skin cancer treatment. For example, Duncan and colleagues 13 found that reimbursements for pT1a melanoma treated with CE-OR and CE-Office were $2,612 and $1,419 respectively, although tumor location and surgical technique were not described. For outpatient surgery, MMS was more expensive than CE-Office in our cohort.…”

“…If these additional costs were included, our results may be similar to the results of older literature describing comparable costs 11,16 for MMS and CE-POMA in skin cancer treatment. Further research is needed to account for the 19) cohorts, which upholds previous findings describing the lower cost of outpatient surgery for melanoma 13 and nonmelanoma [17][18][19] skin cancer treatment. For example, Duncan and colleagues 13 found that reimbursements for pT1a melanoma treated with CE-OR and CE-Office were $2,612 and $1,419 respectively, although tumor location and surgical technique were not described.…”

“…This retrospective cohort study reveals that HNM surgery costs less in the outpatient setting, based on institutional and insurance claims data. To our knowledge, this is one of the earliest studies 13 evaluating the cost of surgical care for HNM surgery using insurance reimbursement data. We add to the literature by comparing costs between CE-OR, MMS, and CE-Office, whereas previous HNM literature describes the cost of CE-POMA in the OR and office-based setting.…”

“…We add to the literature by comparing costs between CE-OR, MMS, and CE-Office, whereas previous HNM literature describes the cost of CE-POMA in the OR and office-based setting. 13 This cost analysis contributes to the literature by describing the cost hierarchy of HNM surgery (CE-OR.MMS.CE-Office) and comparing costs of MMS with CE-Office and CE-OR. CE-Office exhibited the lowest cost in the institutional ($1376.45, 95% CI: $686.17-$1593.75) and insurance claims cohort ($2043.98, 95% CI: $1434.67-$2653.29).…”

“…The cost benefit of MMS in nonmelanoma skin cancer treatment has been described, 11,12 but there is a paucity of data evaluating the cost of care for melanoma surgery. There is evidence suggesting lower cost of the outpatient setting in melanoma treatment, 13 yet a cost comparison including MMS and describing HNM is lacking.…”