Core-needle and surgical breast biopsy: Comparison of three methods of assessing cost

PURPOSE: To compare and evaluate the measures of cost for core-needle and surgical breast biopsies. MATERIALS AND METHODS: Three measures of costs were evaluated; (a) input resources, (b) actual payments, and (c) billed charges. A combination of methods were used for data collection from 10 sites enrolled in a large-scale, multiinstitutional, randomized controlled clinical trial. RESULTS: Input resource cost data (42 core-needle and eight surgical biopsies) were the most difficult to obtain. Actual payments and billed charges data collection (32 core-needle and 44 surgical biopsies) was hampered by the difficulty of obtaining data from all providers involved in the procedures. Average direct input resource costs for surgical biopsy (including needle localization) were almost three times as high a those for core-needle biopsy ($698 vs $243). Actual payments ($2,398 vs $799) and billed charges ($3,764 vs $1,496) for surgical biopsy averaged two and a half to three times higher than those for core biopsy (P < .001). CONCLUSION: There was remarkable consistency in relative costs. Input resource costs were much more difficult to obtain than were either actual payments or billed charges. However, input resource costs present a more reliable indication of the actual costs of a procedure than do the other measures. Given the difficulty in obtaining input resource costs, analyses by using actual payments may be preferred.