Mohs micrographic surgery (MMS) is less expensive and more effective than wide local excision (WLE) for stage T2a cutaneous squamous cell carcinoma (cSCC), according to a study published in the February issue of the Journal of the American Academy of Dermatology .

Jeremy Udkoff, M.D., from the University of Pittsburgh Medical Center, and colleagues conducted a cost-effectiveness analysis to determine whether MMS is effective compared to WLE for Brigham and Women's Hospital stage T2a cSCC. A Markov model was created using variables from published data with a five-year time horizon.

The researchers found that MMS was less expensive than WLE ($4,365.57 versus $4,699.41). Over five years, MMS gained 2.22 weeks of perfect health (3.776 and 3.733 quality-adjusted life years [QALY] for MMS and WLE, respectively). The incremental cost-effectiveness ratio for WLE versus MMS was –$7,822.19 for stage T2a cSCC. The probability of being more cost-effective was 99.9 percent for MMS versus WLE. Choosing MMS over WLE would result in annualized savings of $200 million and more than 25,000 QALY. MMS would remain cost-effective if it cost 3.1 times the current rate.

"Providing these data to physicians, policy makers, and insurance companies represents an important step in methodologically examining available therapies to help ease the fiscal strains on our health care system while providing better outcomes for patients," the authors write.

Abstract/Full Text (subscription or payment may be required)