Cost-effectiveness of surgical excision versus Mohs micrographic surgery for nonmelanoma skin cancer: A retrospective cohort study.
BACKGROUND
Nonmelanoma skin cancer rates are increasing worldwide. Mohs micrographic surgery and surgical excision (SE) are the two treatment methods for this type of cancer. The current paper aims at determining and comparing the cost-effectiveness of SE and Mohs micrographic surgery.


METHODS
The current study has a retrospective cohort design. A number of 630 patients suffering from nonmelanoma skin cancer who at some point of time during the years 2007-2014 referred to the Al-Zahra or Seyed Al-Shohada Hospitals in Isfahan. Patients were followed up for 4 years, and then the incremental cost-effectiveness ratio (ICER) of the two methods was calculated.


RESULTS
The average (minimum-maximum) cost of the SE and Mohs surgery methods in Iran was obtained as 18,550,170 (2335,800-260,898,262) and 12,236,890 (6488,340-41,161,700) Iranian Rial, respectively. Recurrence percentage was also reported as 7.9% and 8.7% for SE and Mohs micrographic surgery, respectively (P> 0.05). The ICER of SE in comparison with Mohs surgery was calculated as 7891,600 Iranian Rials per recurrence avoided.


CONCLUSIONS
Mohs surgery is less expensive than SE, it seems like Mohs surgery is more affordable, however further studies in different populations of the country are needed.
Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Leila
L
Nassiripour
Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran; Isfahan Pharmaceutical Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Mohammadreza
M
Amirsadri
General Surgeon, Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Maryam
M
Tabatabaeian
Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Mohammad Reza
MR
Maracy
Cost-effectiveness; Mohs micrographic surgery; nonmelanoma skin cancer; surgical excision