Malignant melanoma: cost and reimbursement issues.

Once malignant melanoma has spread below the epidermis and metastasized, the response rate to conventional therapy is relatively poor. Investigational drug programs currently are exploring a number of promising treatment options, including biologic therapy (alpha interferon and interleukin-2) and immunotherapy. However, the costs of investigational drug therapy are high, and there are signs that the federal government and third-party payers are increasingly reluctant to reimburse patient expenses for participation in clinical drug trials. Unless financial support for investigational therapy is maintained, conventional therapy with low rates of cure will continue to be reimbursed while the use of state-of-the-art research drugs will slow to a halt.