Cost of nonmelanoma skin cancer treatment in the United States.
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.


CONCLUSIONS
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.
Chen
J G
JG
Bristol-Myers Squibb Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1071, USA.
Fleischer
A B
AB
Smith
E D
ED
Kancler
C
C
Goldman
N D
ND
Williford
P M
PM
Feldman
S R
SR
D000556:Ambulatory Surgical Procedures; D001706:Biopsy / Q000191:economics; D002280:Basal Cell Carcinoma / Q000191:economics* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000191:economics* / Q000601:surgery; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D009819:Office Visits / Q000191:economics; D012878:Skin Neoplasms / Q000191:economics* / Q000601:surgery; D014481:United States