Table 2. Costs Per Grouped Interventions
|
Item |
Cost |
|
Primary lesion work-up and treatment |
|
|
Initial consult dermatologist |
$375.00 |
|
Medical oncologist (in 20.5% of patients representing T4 where consult is needed) |
$375.00 |
|
Skin biopsy, pathology and reading, wide local excision (WLE) |
$1,935.19 |
|
Total baseline procedures |
$2310.19 |
|
Total + medical oncologist (when needed) |
$2,685.20 |
|
Additional: |
|
|
Skin flap |
$890.60 |
|
Skin graft |
$1,246.80 |
|
Mohs micrographic surgery |
$1,732,10 |
|
Office excision with HE sections |
$1,271,30 |
|
Ambulatory surgical excision with frozen sections |
$2214,85 |
|
Sentinel LN dissection (SLN) |
|
|
Initial consult medical oncologist + SR |
$375 x 2 |
|
Surgical procedure |
$2536.98 |
|
Pathology reading |
$234.82 |
|
Total |
$3,521.80 |
|
Total LN dissection (TLND) |
|
|
Initial consult medical oncologist + SR |
$375 x 2 |
|
Surgical procedure |
$2,386.98 |
|
Pathology reading |
$903.15 |
|
Total |
$4,039.75 |
|
IFN-alpha treatment (1 y course and added the cost of complications: 5% neutropenic fever + 5% admission for other reasons) |
$75,955.18 |
|
In-transit metastases |
|
|
Primary lesion (surgical resection x 2) |
$2,310.19 x 2 |
|
Medical oncologist visit (x 2) |
$375.00 |
|
Surgical visits |
$375.00 x 2 |
|
Whole LN dissection (x 75%) |
$4,039.75 x 75% |
|
Total |
$8,775.20 |
|
Metastatic lesions work-up and treatment |
|
|
Biopsy and reading |
|
|
IR |
$2,700.00 |
|
Pathology |
$53.71 + $34.95x3 |
|
Total |
$2966.91 |
|
Central line |
$3,600.00 |
|
Chemotherapy monthly: $19,671.00 x 8 months $1,967.10 x 8 months |
$15,736.80 |
|
Head scans x 2 (CT and PET) = |
$5476.20 |
|
Follow-up treatment, 4 scans at 2 months x 8 months |
$24,414.40 |
|
PET (x 2 ) |
$10,242.80 |
|
Medical oncologist visit 3 months = $155 + 24 lab work = ($223 + $8.60) x 24 = $9278.40 |
$886.00 |
|
Specialty consults x 2 |
$(280+233)x2=$1006.00 |
|
Catheter access 4 months: $98.50 x4 = $394.00 x 8 months |
$3152.00 |
|
Neutropenic fever 1/treatment |
$32,545.67 |
|
Palliative RT (40% of patients) |
40% x $15,000.00 |
|
RT initial consultation |
$375.00 |
|
TOTAL for metastatic lesion = |
$116,294.18 |
|
Follow-up triple visit for nonmetastatic lesion |
|
|
Medical oncologist workup (0 scans and bloodwork) |
$280.00 + $223.00 |
|
Dermatology |
$280.00 |
|
Surgery |
$93.00 |
|
TOTAL for triple visit |
$886.00 |
|
Patient Lost Time |
Time x $16.00/hour |
|
Cost of palliative terminal care |
$14,500.00 |