Scalp cooling and chemotherapy-induced alopecia: Evaluating cost-effectiveness and insurance coverage

Authors

  • Lauren McGrath Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Winston-Salem, NC, USA Author
  • Alice Mikulinsky Wake Forest School of Medicine, Winston-Salem, NC, USA Author
  • Steven Feldman Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA , Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA , Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA Author

DOI:

https://doi.org/10.25251/asnyyf41

Keywords:

chemotherapy-induced alopecia, cold capping, scalp cooling, cost-effectiveness analysis, health economics, insurance coverage

Abstract

Chemotherapy-induced alopecia (CIA) substantially affects patients’ quality of life. Scalp cooling, or cold capping, reduces chemotherapy uptake in hair follicles and can help preserve hair, but insurance coverage remains inconsistent, limiting access. We conducted a cost-effectiveness analysis from a payer perspective comparing scalp cooling with 2 dermatologic management strategies for CIA. The incremental cost-effectiveness ratio (ICER) for scalp cooling was $3,050 per QALY versus dermatologic management plus minoxidil and –$2,950 per QALY versus dermatologic management plus minoxidil and platelet-rich plasma. Both ICERs fall below common United States willingness-to-pay thresholds, indicating that scalp cooling is cost-effective. These findings suggest that scalp cooling is a financially reasonable supportive care intervention and should be considered for routine insurance coverage.

References

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Published

01/05/2026

Issue

Vol. 31 No. 6 (2025): Dermatology Online Journal

Section

Commentary

License

Copyright (c) 2026 Lauren McGrath, Alice Mikulinsky, Steven Feldman (Author)

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.