Modelling the healthcare costs of skin cancer in South Africa

Gordon, Louisa G.; Elliott, Thomas M.; Wright, Caradee Y.; Deghaye, Nicola; Visser, Willie

doi:10.1186/s12913-016-1364-z

BMC Health Services Research

Table 2 Estimated unit costs (2014/2015 South African Rand ZAR and USD) and sources

From: Modelling the healthcare costs of skin cancer in South Africa

	Private sector	Public sector	Weighted cost^a(ZAR)	Weighted cost^a(USD)	Source
Cost of a dermatologist or surgeon visit	458	268	298	51	UPFS tariffs #1012 + #1010 (facility fee level 2)
Cost of a GP visit	335	158	186	32	UPFS tariff #1011 + #1010 (facility fee level 2), private: review of invoices
Cost of a diagnostic biopsy (includes immunohistology)	750	593	618	105	UPFS tariff #1112 + #1110 (facility fee level 2), private: R750 dxbiopsy + excision
Cost of excision	4643	593	1241^b	211	UPFS tariff #1112 + #1110 (facility fee level 2), private: review of invoices
Cost of an excision with reconstructive surgery	4433	2091	2466	418	UPFS tariff #1612 cosmetic surgery cat A -specialist \practitioner + 75 facility fee^b
Cost of cryotherapy	1257	593	699	119	UPFS tariff #1112 + #1110 (facility fee level 2),^b
Cost of topical cream	548	548	548	93	Master procurement list - Imiquimod 5 % 12 sachets #180346230
Cost of photodynamic therapy	2514	1186	1399	237	UPFS tariff #1112 + #1110 (facility fee level 2), need 2 sessions^b
Cost of curettage and cautery	1257	593	699	119	UPFS tariff #1112 + #1110 (facility fee level 2),^b
Cost of radiotherapy - whole course	62334	29403	34672	5884	Annex N for Radiology - MR planning for radiotherapy course (oncol radiotherapy not available) Have used Aust. Price $7325 for whole course^c
Cost of chemotherapy - whole course	31185	31185	31185	5292	Dacarbazine was not on the procurement list therefore price is based on fotemustine, AU $7769 per course^c
Cost of treatment for SCC or BCC in primary care by GP	1018	480	566	96	UPFS tariff #1112 + #1010 (facility fee level 2),^b
Cost of adjuvant immunotherapy with interferon - interferon alpha, 1 syringe injection	367	367	367	62	Master procurement list interferon alpha 2b syringe 9 MIU/0.5 mL #180348820 - daily injection for 10–24 weeks, then 3 ×/week for up to 6 mths
Cost of PET scan	11195	4224	5339	906	UPFS tariff #1952 + #1950 (facility fee level 2), private: review of invoices
Cost of a radical lymph node dissection	6632	593	1559	265	UPFS tariff #1112 + #1010 (facility fee level 2),
Cost of sentinel lymph node biopsy	750	593	618	105	UPFS tariff #1112 + #1010 (facility fee level 2),^b
Cost of follow up	1694	158	404	69	UPFS tariff #1031 + #1010 (facility fee level 2)
Cost of hospitalisation - 1 night for melanoma with SLNB	2105	993	1171	199	UPFS tariff #0612 + #0610 (facility fee level 2) same as day patient #0663^b

UPFS Uniform Patient Fee Schedule, GP general practitioner, SLNB sentinel lymph node biopsy, PETpositron emission tomography, SCC squamous cell carcinoma, BCC basal cell carcinoma, MR magnetic radiation
^aWeighting based on 16 % private and 84 % public [23]. Sensitivity analyses are based on the private and public sector values
^bIn the absence of a private fee, it was assumed a 2.12 to 1.00 ratio of private to public based on the cost of a GP visit differential between private and public sectors
^cConverted to ZAR by http://eppi.ioe.ac.uk/costconversion/default.aspx
Note: Sensitivity values were created with a 15 % change in the public sector probability when weighting the cost. (low = 84 %*0.85;high = 84 %*1.15). For probabilistic sensitivity analyses, gamma distributions were assigned to costs to account for uncertainty

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ISSN: 1472-6963

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