Thomas M Elliott1,2,3, David C Whiteman1,3, Catherine M Olsen1,4, Louisa G Gordon5,6,7,8. 1. Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Q4006, Australia. 2. Menzies Health Institute Queensland, Centre for Applied Health Economics, Griffith University, Logan Campus, University Dr, Meadowbrook, Q4131, Australia. 3. Centre for Research Excellence in Sun and Health Queensland, University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, Q4059, Australia. 4. School of Public Health, The University of Queensland, Brisbane, Australia. 5. Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Q4006, Australia. louisa.gordon@qimrberghofer.edu.au. 6. Centre for Research Excellence in Sun and Health Queensland, University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, Q4059, Australia. louisa.gordon@qimrberghofer.edu.au. 7. School of Public Health, The University of Queensland, Brisbane, Australia. louisa.gordon@qimrberghofer.edu.au. 8. School of Nursing, Queensland University of Technology, Brisbane, Australia. louisa.gordon@qimrberghofer.edu.au.
Abstract
BACKGROUND: Skin cancer exerts a large and growing burden on health systems. With new pharmacotherapies for metastatic melanoma now available, a contemporary understanding of the cost burden of melanoma control is warranted. OBJECTIVE: To comprehensively assess the healthcare costs of malignant melanoma diagnosis and treatment in Australia, over 3 years after diagnosis. METHODS: We developed a decision-analytic model and micro-costing method to estimate the mean cost per patient for melanoma, incorporating all diagnostic and treatment modalities used in Australia (2017 AU$). By using the de-identified 10% sample of Medicare Benefits Scheme, we analysed health service use and supplemented our analyses with published estimates. We took a health system cost perspective, and addressed input uncertainty with sensitivity analyses. RESULTS: The mean annual cost per patient for melanoma stage 0/I/II was AU$1681 (US$1175) rising to AU$37,729 (US$26,365) for stage III resectable, and AU$115,109 (US$80,440) for stage III unresectable/IV. Three-year costs for stage III unresectable/IV were AU$187,720. Nationally, the annual estimated cost for treatment of all new cases of in situ and invasive melanomas was AU$201 million (95% CI: AU$187 to AU$216 million). When we included treatments for presumptive melanoma later found to be benign lesions, the estimated annual cost burden reached AU$272 million. CONCLUSION: With rapidly rising treatment costs, there is a need to consider a comprehensive melanoma control strategy that includes primary prevention of skin cancers and cost-effective sun protection initiatives.
BACKGROUND:Skin cancer exerts a large and growing burden on health systems. With new pharmacotherapies for metastatic melanoma now available, a contemporary understanding of the cost burden of melanoma control is warranted. OBJECTIVE: To comprehensively assess the healthcare costs of malignant melanoma diagnosis and treatment in Australia, over 3 years after diagnosis. METHODS: We developed a decision-analytic model and micro-costing method to estimate the mean cost per patient for melanoma, incorporating all diagnostic and treatment modalities used in Australia (2017 AU$). By using the de-identified 10% sample of Medicare Benefits Scheme, we analysed health service use and supplemented our analyses with published estimates. We took a health system cost perspective, and addressed input uncertainty with sensitivity analyses. RESULTS: The mean annual cost per patient for melanoma stage 0/I/II was AU$1681 (US$1175) rising to AU$37,729 (US$26,365) for stage III resectable, and AU$115,109 (US$80,440) for stage III unresectable/IV. Three-year costs for stage III unresectable/IV were AU$187,720. Nationally, the annual estimated cost for treatment of all new cases of in situ and invasive melanomas was AU$201 million (95% CI: AU$187 to AU$216 million). When we included treatments for presumptive melanoma later found to be benign lesions, the estimated annual cost burden reached AU$272 million. CONCLUSION: With rapidly rising treatment costs, there is a need to consider a comprehensive melanoma control strategy that includes primary prevention of skin cancers and cost-effective sun protection initiatives.
Authors: A F Bais; R M Lucas; J F Bornman; C E Williamson; B Sulzberger; A T Austin; S R Wilson; A L Andrady; G Bernhard; R L McKenzie; P J Aucamp; S Madronich; R E Neale; S Yazar; A R Young; F R de Gruijl; M Norval; Y Takizawa; P W Barnes; T M Robson; S A Robinson; C L Ballaré; S D Flint; P J Neale; S Hylander; K C Rose; S-Å Wängberg; D-P Häder; R C Worrest; R G Zepp; N D Paul; R M Cory; K R Solomon; J Longstreth; K K Pandey; H H Redhwi; A Torikai; A M Heikkilä Journal: Photochem Photobiol Sci Date: 2018-02-14 Impact factor: 3.982
Authors: Nathaniel C Holcomb; Robert-Marlo Bautista; Stuart G Jarrett; Katharine M Carter; Madeline Krentz Gober; John A D'Orazio Journal: Adv Protein Chem Struct Biol Date: 2018-12-05 Impact factor: 3.507
Authors: Louisa G Gordon; Astrid J Rodriguez-Acevedo; Brian Køster; Gery P Guy; Craig Sinclair; Emilie Van Deventer; Adèle C Green Journal: JAMA Dermatol Date: 2020-04-01 Impact factor: 10.282
Authors: Louisa Gordon; Catherine Olsen; David C Whiteman; Thomas M Elliott; Monika Janda; Adele Green Journal: BMJ Open Date: 2020-02-26 Impact factor: 2.692
Authors: Pauline Zaenker; Johnny Lo; Robert Pearce; Phillip Cantwell; Lester Cowell; Mark Lee; Christopher Quirk; Henry Law; Elin Gray; Mel Ziman Journal: Oncotarget Date: 2018-07-17
Authors: Mbathio Dieng; Nikita Khanna; Mai Thi Hoang Nguyen; Robin Turner; Sarah J Lord; Alexander M Menzies; Jay Allen; Robyn Saw; Omgo E Nieweg; John Thompson; Rachael L Morton Journal: BMJ Open Date: 2020-11-05 Impact factor: 2.692