Variation in cost of actinic keratosis management

(HealthDay)—There is considerable variation in the cost of actinic keratosis (AK) management, according to a study published online March 1 in JAMA Dermatology.

Joslyn S. Kirby, M.D., from the Penn State Milton S. Hershey Medical Center, and colleagues conducted a retrospective cohort study using data from the MarketScan medical claims database of 488,324 continuously enrolled members with two or more claims for AK.

The researchers found that there were 1,085,985 claims related to AK, with dermatologists accounting for 71.0 percent of claims. The total two-year cost was $111.5 million: $52.4 million and $59.1 million in 2011 and 2012, respectively. There was variation in the unadjusted ratio of mean cost in the highest quintile versus the lowest quintile (Q5:Q1) from 9.49 to 15.10. After adjustment, the ratios varied from 1.72 to 1.80.

"There is variation in AK management cost within and between regions. This is not fully explained by differences in patient characteristics such as age, sex, or comorbidities," the authors write. "The annual cost for 10 common conditions from Medicare had lower Q5:Q1 ratios that ranged from 1.33 (joint degeneration of back/neck) to 1.69 (chronic sinusitis) when compared with 1.72 to 1.80 for AKs."