Scalp Cooling and Chemotherapy-Induced Alopecia: Evaluating Cost-Effectiveness and Insurance Coverage

January 2026 in “ Dermatology Online Journal ”

Lauren M. McGrath, Alice L. Mikulinsky, Steven Feldman

scalp cooling chemotherapy-induced alopecia minoxidil platelet-rich plasma dermatologic management Rogaine PRP

TLDR Scalp cooling is cost-effective for reducing hair loss from chemotherapy and should be covered by insurance.

Scalp cooling, a method to reduce chemotherapy-induced alopecia (CIA), is cost-effective compared to dermatologic management strategies, with an incremental cost-effectiveness ratio (ICER) of $3,050 per QALY versus dermatologic management plus minoxidil and –$2,950 per QALY versus dermatologic management plus minoxidil and platelet-rich plasma. These ICERs are below common U.S. willingness-to-pay thresholds, suggesting that scalp cooling is a financially viable supportive care intervention. The study advocates for routine insurance coverage of scalp cooling to improve access and support patients' quality of life during chemotherapy.

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