Table 2.
Cost and Utility Parameters
| Parameter | Base Case Value | Range Examined | Reference |
|---|---|---|---|
| Costs | |||
| Cost of Level IV ENT Outpatient Consult | $152 | - | ∞ |
| Cost of Level IV established visit to primary care provider or otolaryngologist | $68 | - | ∞ |
| Cost of office biopsy | $92 | $0–$200 | ∞ |
| Cost of excisional tongue biopsy | $110 | - | ∞ |
| Cost of pre-operative labs, chest x-ray and EKG | $72 | - | ∞ |
| Cost of surveillance PET scan (skull base to mid-thigh) | $950 | - | Ω |
| Cost of pre-operative PET/CT scan (skull base to mid-thigh) | $1,068 | - | Ω |
| Cost of pre-operative CT neck with contrast | $351 | - | Ω |
| Surgeon fee for unilateral suprahyoid neck dissection | $1,274 | - | ∞ |
| Surgeon fee for excision of Stage I/II lesion | $219 | - | ∞ |
| Surgeon fee for composite resection for Stage III/IV disease | $1,935 | - | ∞ |
| Surgeon fee for free flap reconstruction | $2,586 | - | ∞ |
| Surgeon fee for tracheotomy | $377 | - | ∞ |
| Inpatient costs for Stage I/II surgery (partial glossectomy with unilateral neck dissection) | $10,101 | $5,000–$15,000 | 2007 median cost, HCUPnet 29 |
| Inpatient costs for Stage III/IV surgery (mandibulectomy with reconstruction) | $24,842 | $10,000–$40,000 | 2007 median cost, HCUPnet 29 |
| Chemotherapy | $5,769 | $2,000–$10,000 | 30 |
| Intensity-modulated radiation therapy | $22,219 | $5,000–$30,000 | 31 |
| Total Stage I/II Treatment Costs Year 1 | $11,600 | - | ∞ 29 |
| Total Stage III/IV Treatment Costs Year 1 | $61,900 | $30,000–120,000 | ∞ 29 |
| Willingess-to-pay Threshold | $75,000 per QALY | $50,000–150,000 per QALY | 39 |
| Utilities | |||
| Baseline utility | 0.84 | 0.7–1 | 32 |
| Precancer | 0.92 | 0.9–1 | 33 |
| Stage I/II cancer | 0.88 | 0.7–1 | 33 |
| Stage III/IV cancer | 0.68 | 0.5–1 | 33 |
∞
= Medicare payment to Pennsylvania Area 99 based on 2009 Current Procedural Terminology Codes
Ω
= Federal Register, Volume 71, No. 226, November 24, 2006