The economic burden of melanoma in France: assessing healthcare use in a hospital setting.

The objective of this experiment was to describe healthcare use for the treatment of melanoma in a hospital setting and to assess the related annual cost using French hospital records for the year 2004. The 2004 French national database was the main source of data. Hospital stays related to melanoma care were extracted from this database, which exhaustively records hospital stays in the country. We selected stays that included at least one diagnosis of melanoma: International Classification of Diseases (ICD)-10 codes C43 'malignant melanoma of skin' or D03 'melanoma in situ'. A second database (the French National Hospital Costs Survey) was used to compute unit costs. For each diagnosis-related group involved in melanoma care, we calculated an average cost per day from this database. Unit costs were then applied to the duration of each hospital stay related to melanoma from the 2004 national database. A total of 42,911 stays related to melanoma were identified for the year 2004. New patients, estimated by the number of surgical stays with a melanoma ICD code as the main diagnosis, amounted to 6897. Annual hospital costs for melanoma care were estimated at 59 million euros. Almost half of these costs (27 million euros) were attributable to stays with a metastasis ICD code. The main cost drivers were surgery (38% of hospital costs), follow-up evaluations (20%) and chemotherapy (17%). It was concluded that the impact of melanoma on hospital expenditures for cancer was modest. Hospital costs for stays related to melanoma represented less than 1% of total annual hospital costs for cancer for the year 2004.