title: Explicit and implicit copayments for phototherapy: examining the cost of commuting.
abstract: BACKGROUND
  Whereas phototherapy is a safe and cost-effective treatment modality for psoriasis, economic disincentives discourage its use, including both direct and indirect costs to the patient.
  
  
  OBJECTIVE
  To determine when it may be cost-effective for patients to purchase a home light unit versus driving to clinic for outpatient phototherapy sessions.
  
  
  METHODS
  Estimates of expenses associated with 3 months of outpatient phototherapy were determined and compared to the price of a home phototherapy unit. Factors examined included the cost of gasoline (based on the national average), fuel efficiency of the vehicle, cost of owning and operating a motor vehicle, lost wages, and copayments.
  
  
  RESULTS
  The cost for a standard 6-bulb narrowband UVB home unit is approximately $2600. Direct and indirect expenses imposed on patients increase with distance travelled to the dermatologist. If a patient lives 20 or more miles away from the dermatologist, the expenses associated with travel can total more than the out of pocket expense of purchasing a home phototherapy unit.
  
  
  CONCLUSIONS
  This small analysis only accounted for the first 3 months of treatment and likely underestimates the total costs that patients would experience over a lifetime of treatment.
  
  
  CONCLUSIONS
  It may be beneficial for physicians to educate patients on the cost-burden of in-office versus home phototherapy because patients can use these parameters to determine which option would be more cost-effective for them.
authors.affiliation: Center for Dermatology Research, Departments of Dermatology, Pathology and Public Health Sciences, Winston-Salem, North Carolina, USA.
authors.forename: Brad A
authors.initials: BA
authors.lastname: Yentzer
authors.forename: Cheryl J
authors.initials: CJ
authors.lastname: Gustafson
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
mesh_terms: D000041:Absenteeism; D000553:Ambulatory Care / Q000191:economics*; D001336:Automobiles / Q000191:economics; D017046:Cost Savings / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D005742:Gasoline / Q000191:economics; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000191:economics; D006801:Humans; D008029:Lighting / Q000191:economics; D009657:North Carolina; D009819:Office Visits / Q000191:economics; D010353:Patient Education as Topic; D014186:Transportation / Q000191:economics*; D014467:Ultraviolet Therapy / Q000191:economics* / Q000295:instrumentation
chemical_list: D005742:Gasoline