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Periocular basal cell carcinoma: cost of topical immunotherapy versus estimated cost of surgical treatment Carcinoma basocelular periocular: custo da imunoterapia tópica versus custo estimado do tratamento cirúrgico

DOI: 10.1590/s0034-72802012000300007

Keywords: Carcinoma basocelular , Carcinoma basocelular , Carcinoma basocelular , Neoplasias palpebrais , Antineoplásicos , Biópsia , Custos de cuidados de saúde , Carcinoma , basal cell carcinoma , Carcinoma , basal cell , Carcinoma , basal cell carcinoma , Eyelid neoplasms , Antineoplastic agents , Biopsy , Health care costs

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PURPOSE: The objective of this study was to compare the estimated cost of clinical and surgical treatment for basl cell carcinoma of the eyelid. METHODS: This was a pilot study of 12 patients with basal cell carcinoma receiving treatment with 5% imiquimod cream at the ocular plastic surgery center, medical school University of S o Paulo (HC-FMUSP, Brazil). The cost of clinical treatment was estimated based on the time of treatment and amount of medication consumed by patients in the home setting. The cost of surgical treatment was estimated by ophthalmologists with experience in reconstructive plastic surgery based on analysis of images of the same patients. Surgeons responded to a questionnaire with four questions about surgical technique, surgical materials required, estimated duration of surgery and type of anesthesia. RESULTS: Immunotherapy lasted from 8 to 12 weeks.All patients reported each coldstored sachet with 5% imiquimod cream lasted 3 days.According to the institution, a box with 12 sachets costs BRL 480.00. Patients required 1.58-3.11 boxes for complete treatment, corresponding to a total cost of BRL 758.401,492.80. Based on image analysis, surgeons evaluated surgery would require 1-3 hours. The estimated cost of surgery room and staff was BRL 263.00, to which the cost of supplies was added. Thus, the total cost of surgical treatment was BRL 272.61-864.82. On the average, immunotherapy was 57,64% more costly than surgical treatment. CONCLUSIONS: Malignant eyelid tumors are a common finding in clinical ophthalmology. Surgery is still the treatment of choice at our institution, but immunotherapy with 5% imiquimod cream may be indicated for patients with multiple lesions or high surgical risk and for patients declining surgery for reasons of fear or esthetic concerns.The ability to estimate costs related to the treatment of malignant eyelid tumors is an important aid in the financial planning of health care institutions. Further studies should evaluate the possibility of institutions equating the cost of immunotherapy and surgical treatment by acquiring similar but less expensive medications. OBJETIVO: O objetivo deste estudo foi comparar os custos do tratamento clínico e cirúrgico para carcinoma basocelular palpebral. MéTODO: Neste estudo piloto, doze pacientes com carcinoma basocelular atendidos no departamento de Plástica Ocular do Hospital das Clínicas da Universidade de S o Paulo (HC-FMUSP) foram tratados com imiquimode creme 5%. O Custo do tratamento clínico foi estimado baseado no tempo de tratamento e quantidade de medica o utilizada p


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