Variation in Utilization and Spending for the Management of Actinic Keratosis

Variation in Utilization and Spending for the Management of Actinic Keratosis

Importance: In 2004, the US health care spending for actinic keratosis (AK) management was $1.2 billion so any change in the money spent per person could equate to large cost differences due to the high prevalence.
Objective: To assess AK-specific healthcare utilization and costs and the impact of minimizing extremes of utilization and spending.
Methods: Retrospective cohort study, using data from a large private insurer for the mid-Atlantic region for the period of January 2010 to December 2012.
Results: The total cost of AK-related care was $40,719,495 for 95,294 patients with AK; prescriptions accounted for 8.6% and outpatient care for 91.4%. The use of extensive destruction (CPT 17004), prescription therapy, male gender and age were associated with a higher mean three-year cost per patient. The mean threeyear cost was $447.74; when outliers outside of the 1st and 99th percentile and 5th and 95th percentiles were replaced, the mean decreased by about $35 or $64, respectively.
Conclusions and relevance: Age, gender, and treatment factors all influence the total cost of AK management. The mean and total costs for are sensitive to the effects of outliers.