The Cost-Effectiveness of Sentinel Node Biopsy in Patients with Intermediate Thickness Primary Cutaneous Melanoma
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- Morton, R.L., Howard, K. & Thompson, J.F. Ann Surg Oncol (2009) 16: 929. doi:10.1245/s10434-008-0164-z
The aim of this study was to determine the cost-effectiveness of wide excision (WEX) + sentinel node biopsy (SNB) compared with WEX only in patients with primary melanomas ≥1 mm in thickness.
A Markov model was populated with probabilities of disease progression and survival from the published literature. Costs were obtained from diagnostic-related group weightings and health outcomes were measured in quality-adjusted life years (QALYs).
Base case analyses suggested that, over a 20–year timeframe, the mean total cost per patient receiving WEX only was AU $23,182 with 10.45 life years (LY) and 9.90 QALYs. The mean cost per patient for WEX + SNB was AU $24,045 with 10.77 LY and 10.34 QALYs. The incremental cost effectiveness ratio for WEX + SNB was AU $2,770 per LY and AU $1,983 per QALY.
WEX + SNB appears to offer an improvement in health outcomes (in both LYs and QALYs) with only a slight increase in cost.