title: Cost analysis of implant-based breast reconstruction with acellular dermal matrix.
abstract: 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.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: de Blacam
authors.forename: Adeyiza O
authors.initials: AO
authors.lastname: Momoh
authors.forename: Salih
authors.initials: S
authors.lastname: Colakoglu
authors.forename: Sumner A
authors.initials: SA
authors.lastname: Slavin
authors.forename: Adam M
authors.initials: AM
authors.lastname: Tobias
authors.forename: Bernard T
authors.initials: BT
authors.lastname: Lee
mesh_terms: D062088:Acellular Dermis / Q000191:economics*; D019928:Breast Implantation / Q000191:economics* / Q000379:methods; D018427:Breast Implants / Q000191:economics*; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D011446:Prospective Studies