The medical charge analysis using the charge estimates and actual patient bills revealed that for the Medicare patient, the least expensive initial treatment option was transoral endoscopic removal (assigned a median of 100 for both costing methods). The most expensive initial treatment option was partial vertical laryngectomy (289 and 339 respectively). Radiotherapy was intermediate in expense (137 using charge estimates and 156 using actual patient bills). For the non-Medicare patient, the charge estimates indicate that the least expensive initial treatment option was transoral endoscopic removal (170); partial vertical laryngectomy was the most expensive initial option (391) and radiotherapy was intermediate (316). The use of patient bills indicated that the median charge for transoral endoscopic removal, radiotherapy and partial vertical laryngectomy would be 174, 409 and 532 respectively. The medical cost analysis using the total standard costs revealed that the least costly treatment was transoral endoscopic removal, which was assigned a median 1995 health care cost value of 100 (range: 75 - 298, n=13). Partial vertical laryngectomy was the most costly treatment, with a median 1995 health care cost value of 397 (range: 219 - 538, n=10). Radiotherapy was intermediate, with a median cost of 220 (range: 107 - 358, n=18).
Taking into account the charges and costs of re-treatment, and using the overall charge estimates for the Medicare patient, resulted in radiotherapy being the least expensive treatment (137), compared to transoral endoscopic removal (150) and partial vertical laryngectomy (310). For the non-Medicare patient, transoral endoscopic removal remained the least expensive treatment (260) but was closer to the expense of radiotherapy (316). Partial vertical laryngectomy remained the most expensive (435).
Using the overall actual patient bills for the Medicare patient, transoral endoscopic removal and radiotherapy had the same charge value of 156. Partial vertical laryngectomy was the most expensive at 362. For the non-Medicare patient, transoral endoscopic removal remained the least expensive treatment, at 286, followed by radiotherapy (409) and partial vertical laryngectomy (587). When considering overall resources used or overall total standard costs, transoral endoscopic removal remained the least costly treatment (168) but was closer to the cost of radiotherapy (220). Partial vertical laryngectomy remained the most costly treatment (427)