Surgical versus medical treatment of ocular surface squamous neoplasia a cost comparison

Christina S. Moon, Afshan A. Nanji, Anat Galor, Kathryn E. McCollister, Carol L. Karp

Research output: Contribution to journalArticle

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Abstract

Purpose The objective of this study was to compare the cost associated with surgical versus interferon-alpha 2b (IFNα2b) treatment for ocular surface squamous neoplasia (OSSN). Design A matched, case-control study. Participants A total of 98 patients with OSSN, 49 of whom were treated surgically and 49 of whom were treated medically. Methods Patients with OSSN treated with IFNα2b were matched to patients treated with surgery on the basis of age and date of treatment initiation. Financial cost to the patient was calculated using 2 different methods (hospital billing and Medicare allowable charges) and compared between the 2 groups. These fees included physician fees (clinic, pathology, anesthesia, and surgery), facility fees (clinic, pathology, and operating room), and medication costs. Time invested by patients was calculated in terms of number of visits to the hospital and compared between the 2 groups. Parking costs, transportation, caregiver wages, and lost wages were not considered in our analysis. Main Outcome Measures Number of clinic visits and cost of therapy as represented by both hospital charges and Medicare allowable charges. Results When considering cost in terms of time, the medical group had an average of 2 more visits over 1 year compared with the surgical group. Cost as represented by hospital charges was higher in the surgical group (mean, $17 598; standard deviation [SD], $7624) when compared with the IFNα2b group (mean, $4986; SD, $2040). However, cost between the 2 groups was comparable when calculated on the basis of Medicare allowable charges (surgical group: mean, $3528; SD, $1610; medical group: mean, $2831; SD, $1082; P = 1.00). The highest cost in the surgical group was the excisional biopsy (hospital billing $17 598; Medicare allowable $3528), and the highest cost in the medical group was interferon ($1172 for drops, average 8.0 bottles; $370 for injections, average 5.4 injections). Conclusions Our data in this group of patients previously demonstrated equal efficacy of surgical versus medical treatment. In this article, we consider costs of therapy and found that medical treatment involved two more office visits, whereas surgical treatment could be more or equally costly depending on insurance coverage.

LanguageEnglish (US)
Pages497-504
Number of pages8
JournalOphthalmology
Volume123
Issue number3
DOIs
StatePublished - Mar 1 2016
Externally publishedYes

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Costs and Cost Analysis
Neoplasms
Medicare
Fees and Charges
Therapeutics
Hospital Charges
interferon alfa-2b
Salaries and Fringe Benefits
Pathology
Office Visits
Injections
Insurance Coverage
Operating Rooms
Ambulatory Care
Interferons
Caregivers
Case-Control Studies
Anesthesia
Outcome Assessment (Health Care)
Physicians

ASJC Scopus subject areas

  • Ophthalmology

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Surgical versus medical treatment of ocular surface squamous neoplasia a cost comparison. / Moon, Christina S.; Nanji, Afshan A.; Galor, Anat; McCollister, Kathryn E.; Karp, Carol L.

In: Ophthalmology, Vol. 123, No. 3, 01.03.2016, p. 497-504.

Research output: Contribution to journalArticle

Moon CS, Nanji AA, Galor A, McCollister KE, Karp CL. Surgical versus medical treatment of ocular surface squamous neoplasia a cost comparison. Ophthalmology. 2016 Mar 1;123(3):497-504. Available from, DOI: 10.1016/j.ophtha.2015.10.043
Moon, Christina S. ; Nanji, Afshan A. ; Galor, Anat ; McCollister, Kathryn E. ; Karp, Carol L./ Surgical versus medical treatment of ocular surface squamous neoplasia a cost comparison. In: Ophthalmology. 2016 ; Vol. 123, No. 3. pp. 497-504
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