title: Costs of Keratinocyte Carcinoma (Nonmelanoma Skin Cancer) and Actinic Keratosis Treatment in the Veterans Health Administration.
abstract: BACKGROUND
  The Veterans Health Administration (VHA) provides health care to large numbers of veterans afflicted with keratinocyte carcinoma (KC).
  
  
  OBJECTIVE
  To estimate the number of veterans treated for KCs and the related diagnosis, actinic keratosis (AK) and the costs of treating these conditions over a 1-year period.
  
  
  METHODS
  The authors conducted a cross-sectional analysis of veterans diagnosed with KC or AK during fiscal year 2012 using administrative data on outpatient encounters and prescription drugs provided or paid by VHA. Marginal costs of each condition were estimated from a regression model. The authors estimated counts of outpatient encounters, procedures, and costs related to KC and AK care.
  
  
  RESULTS
  In 2012, there were 49,229 veterans with basal cell carcinoma, 26,310 veterans with squamous cell carcinoma, and 8,050 veterans with unspecified invasive KC. There were also 197,041 veterans with AK and 6,388 veterans with KC-related diagnoses. The VHA spent $356 million on KC and AK outpatient treatment for procedures, prescription drugs, and other dermatologic care during FY2012.
  
  
  CONCLUSIONS
  There was high prevalence of KC and AK and considerable spending to treat these conditions in VHA. Treatment costs are not generalizable to care provided by non-VHA providers where a facility fee was not incurred.
authors.affiliation: *Health Economics Resource Center, Veterans Affairs Palo Alto Health Care System, Menlo Park, California; †Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA; ‡Center for Dermatoepidemiology, VA Medical Center, Providence, Rhode Island; Departments of §Dermatology, and ‖Epidemiology, Brown University, Providence, Rhode Island; ¶Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island.
authors.forename: Jean
authors.initials: J
authors.lastname: Yoon
authors.forename: Ciaran S
authors.initials: CS
authors.lastname: Phibbs
authors.forename: Adam
authors.initials: A
authors.lastname: Chow
authors.forename: Hyemin
authors.initials: H
authors.lastname: Pomerantz
authors.forename: Martin A
authors.initials: MA
authors.lastname: Weinstock
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D002280:Basal Cell Carcinoma / Q000453:epidemiology / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000628:therapy*; D003430:Cross-Sectional Studies; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D055623:Keratosis, Actinic / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012878:Skin Neoplasms / Q000453:epidemiology / Q000628:therapy*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000191:economics*; D014728:Veterans / Q000706:statistics & numerical data*