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If one carefully reads the study by Essers et al1 along with the trial published in the Lancet2 on which it is based, it is apparent that the trial did not involve a randomization of patients to Mohs micrographic surgery (MMS) vs surgical excision. Therefore, conclusions about cost and therapeutic effectiveness may be misleading.
Otley CC. Cost-effectiveness of Mohs Micrographic Surgery vs Surgical Excision for Basal Cell Carcinoma of the Face. Arch Dermatol. 2006;142(9):1231-1244. doi:10.1001/archderm.142.9.1235-a