Mohs Versus Traditional Surgical Excision for Facial and Auricular Nonmelanoma Skin Cancer: An Analysis of Cost-Effectiveness

Abstract

Mohs may be more cost-effective than traditional excision in eradicating nonmelanoma skin cancer. Further investigation of costs from various geographic payment localities and assessment of quality-of-life outcomes from a population-based sample are needed.

AAD/ACMS/ASDSA/ASMS 2012 appropriate use criteria for Mohs micrographic surgery: A report of the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery

“…187,[194][195][196][197] Panel members were not provided detailed, explicit cost information in determining their appropriate use ratings, although they were provided access to 8 published US studies with related information. [198][199][200][201][202][203][204][205] In review of this information, they were asked to implicitly consider cost as an additional factor in their evaluation of appropriate use.…”

The safety of Mohs surgery: A prospective multicenter cohort study

“…1 The cost-effectiveness of Mohs surgery has also been established. [2][3][4][5] Complications associated with Mohs surgery have been evaluated by prospective single-surgeon studies, as well as by retrospective multiple-surgeon studies. [6][7][8][9] Multicenter, prospective studies afford a higher level of clinical evidence and help to establish the safety profile of Mohs surgery in the ambulatory setting.…”

Direct Cost-Analysis of Mohs Micrographic Surgery and Traditional Excision for Basal Cell Carcinoma at Initial Margin Clearance

“…16 Seidler's group used a simple probabilistic decision model to report that MMS was US$292 less expensive and yielded 0.056 additional QALYs compared with TE and was accordingly the dominant intervention. 5 From a health economics perspective, this is the best evidence to date regarding the costeffectiveness of MMS versus TE; however, further refinement such as the use of Markov modelling would improve the validity of the results obtained.…”

“…4 Seidler and colleagues extrapolated on this study incorporating recurrence and found MMS to be US$292 less expensive. 5 Blázquez-Sánchez and colleagues reviewed 79 patients with 81 facial BCC and found MMS was €117 more expensive to initial margin clearance. 6 The literature to date provides mixed results regarding cost comparison of MMS and TE, and to date, no direct cost-analysis has been completed reflecting the Australian experience and Australian Medicare Benefit Scheme (MBS) costings.…”

“…There have been 5 cost analyses published comparing true costs of skin cancer treated with MMS with projected costs if the same lesions had been treated with TE (Table 1). [2][3][4][5][6] Ravitskiy and colleagues 2 reviewed 344 patients with 406 skin cancers and accounting for tumor recurrence, reported MMS was on average US$221 less expensive. Cook and Zitelli 3 reviewed 311 patients with 400 skin cancers and accounting for recurrence, reported MMS was $US76 more expensive.…”