Physicians Opting for High-Cost Skin Cancer Treatments

Skin cancer doctors and dermatologists may be tempted to over-treat patients with minor skin cancers in order to make a financial profit for performing higher-cost procedures, according to a symposium focusing on controversies in dermatology.

A presentation entitled “Inconvenient Truths in Skin Cancer Care” was delivered at the 26th European Academy of Dermatology and Venereology Congress by Dr Tamar Nijsten from Erasmus Medical Center in the Netherlands. The presentation highlighted concerns that dermatologists and skin physicians and might perform unnecessary treatments on minor skin cancers such as basal cell carcinoma, or prescribe high-cost drugs offering no advantage over generic-brand counterparts, because these approaches financially benefit the physicians.

Dr Nijsten, who chairs the European Dermato-Epidemiology Network, said that financial ties between dermatologists and pharmaceutical companies are “rife”, and that these relationships inevitably promote using more costly procedures and high-priced drugs than are warranted.

“We’ve seen a rise in every type of skin cancer,” Dr Nijsten said. “For physicians, it’s very profitable because we do procedures, and procedures cost money.”

His presentation alleged that physicians treating cancer often default to using expensive Mohs micrographic surgery to treat primary basal cell carcinomas, despite knowing the lesion is non-aggressive. Other treatments should be considered instead, such as curettage, excision, cryotherapy, or even topical creams.

There are guidelines in place to attempt to stop skin doctors and dermatologists from resorting to high-cost methods. One statement issued by the American Academy of Dermatology specifically cautions, “Do not treat uncomplicated, non-melanoma cancers less than one centimetre in size on the trunk and extremities with Mohs micrographic surgery.”

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Salamon, M. (17 September, 2017.) ‘Follow the Money’ in Extreme Skin Cancer Care. Medscape Medical News.

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