D. Sebaratnam , , B. Choy , M. Lee , R. Paver , , P. Fernández Peñas ,
Introduction: The cost-effectiveness of Mohs micrographic
surgery (MMS) in the setting of non-melanoma skin
cancer is a contentious topic. The studies published to date
offer mixed conclusions with no clear consensus regarding
its economic utility available.
Aim: To complete a direct cost comparison of MMS and
traditional excision (TE).
Methods: A prospective study was undertaken comparing the true costs of MMS with projected costs of TE. Over one year, 416 consecutive patients receiving MMS were reviewed by the MMS Fellow pre-operatively with surgical management of their BCC with TE and associated closures planned. The projected costs associated with this (including pathological review and further TE in the case of incomplete excision) were compared with the true costs of MMS and associated closures. All costs were determined according to the Medicare Beneﬁts Schedule.
Results: The mean cost of MMS was AUD$882.85 ± 21.46. The mean cost of TE was AUD$683.83 ± 21.21. Of note, 32% of the patients who would have received TE were projected to have had incomplete margins requiring further surgery. Overall, there was a signiﬁcant difference between the cost of MMS and TE (P < 0.01).Discussion: MMS was associated with a higher cost than TE. The difference between interventions is in keeping with what has previously been reported in the literature. To truly determine the cost-effectiveness of MMS compared with TE, a consideration of effectiveness must be incorporated and is mandatory for further work in this area.