Isabelle Tromme1, Catherine Legrand2, Brecht Devleesschauwer3, Ulrike Leiter4, Stefan Suciu5, Alexander Eggermont6, Laurine Sacré7, Jean-François Baurain8, Luc Thomas9, Philippe Beutels10, Niko Speybroeck11. 1. Department of Dermatology, Institut Roi Albert II, Cliniques Universitaires St Luc, Université catholique de Louvain, Brussels, Belgium. Electronic address: Isabelle.tromme@uclouvain.be. 2. Institute of Statistics, Biostatistics and Actuarial Sciences, Université catholique de Louvain, Louvain-la-Neuve, Belgium. 3. Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium. 4. Department of Dermatology, Eberhard Karls University, Tübingen, Germany. 5. European Organization for Research and Treatment of Cancer, Brussels, Belgium. 6. Gustave Roussy Cancer Campus Grand Paris, Villejuif, France. 7. Department of Dermatology, Institut Roi Albert II, Cliniques Universitaires St Luc, Université catholique de Louvain, Brussels, Belgium. 8. Department of Medical Oncology, Institut Roi Albert II, Cliniques Universitaires St Luc, Université catholique de Louvain, Brussels, Belgium. 9. Department of Dermatology, Centre Hospitalier Lyon Sud, Lyon 1 University, Lyons Cancer Research Center, France. 10. Centre for Health Economics Research & Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, Faculty of Medicine & Health Sciences, University of Antwerp, Belgium. 11. Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium.
Abstract
AIM: The main aim of this study is to demonstrate how our melanoma disease model (MDM) can be used for cost-effectiveness analyses (CEAs) in the melanoma detection field. In particular, we used the data of two cohorts of Belgian melanoma patients to investigate the cost-effectiveness of dermoscopy. METHODS: A MDM, previously constructed to calculate the melanoma burden, was slightly modified to be suitable for CEAs. Two cohorts of patients entered into the model to calculate morbidity, mortality and costs. These cohorts were constituted by melanoma patients diagnosed by dermatologists adequately, or not adequately, trained in dermoscopy. Effectiveness and costs were calculated for each cohort and compared. Effectiveness was expressed in quality-adjusted life years (QALYs), a composite measure depending on melanoma-related morbidity and mortality. Costs included costs of treatment and follow-up as well as costs of detection in non-melanoma patients and costs of excision and pathology of benign lesions excised to rule out melanoma. RESULTS: The result of our analysis concluded that melanoma diagnosis by dermatologists adequately trained in dermoscopy resulted in both a gain of QALYs (less morbidity and/or mortality) and a reduction in costs. CONCLUSION: This study demonstrates how our MDM can be used in CEAs in the melanoma detection field. The model and the methodology suggested in this paper were applied to two cohorts of Belgian melanoma patients. Their analysis concluded that adequate dermoscopy training is cost-effective. The results should be confirmed by a large-scale randomised study.
AIM: The main aim of this study is to demonstrate how our melanoma disease model (MDM) can be used for cost-effectiveness analyses (CEAs) in the melanoma detection field. In particular, we used the data of two cohorts of Belgian melanomapatients to investigate the cost-effectiveness of dermoscopy. METHODS: A MDM, previously constructed to calculate the melanoma burden, was slightly modified to be suitable for CEAs. Two cohorts of patients entered into the model to calculate morbidity, mortality and costs. These cohorts were constituted by melanomapatients diagnosed by dermatologists adequately, or not adequately, trained in dermoscopy. Effectiveness and costs were calculated for each cohort and compared. Effectiveness was expressed in quality-adjusted life years (QALYs), a composite measure depending on melanoma-related morbidity and mortality. Costs included costs of treatment and follow-up as well as costs of detection in non-melanomapatients and costs of excision and pathology of benign lesions excised to rule out melanoma. RESULTS: The result of our analysis concluded that melanoma diagnosis by dermatologists adequately trained in dermoscopy resulted in both a gain of QALYs (less morbidity and/or mortality) and a reduction in costs. CONCLUSION: This study demonstrates how our MDM can be used in CEAs in the melanoma detection field. The model and the methodology suggested in this paper were applied to two cohorts of Belgian melanomapatients. Their analysis concluded that adequate dermoscopy training is cost-effective. The results should be confirmed by a large-scale randomised study.