, Volume 16, Issue 4, pp 929-940
Date: 30 Sep 2008

The Cost-Effectiveness of Sentinel Node Biopsy in Patients with Intermediate Thickness Primary Cutaneous Melanoma

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Abstract

Background

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.

Methods

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).

Results

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.

Conclusion

WEX + SNB appears to offer an improvement in health outcomes (in both LYs and QALYs) with only a slight increase in cost.

Contribution of authors.
R. L. Morton conceived and designed the study, undertook the economic modelling, analysed and interpreted the results and wrote the manuscript.
K. Howard contributed to the design and structure of the study, undertook the economic modelling, analysed and interpreted the results and revised the manuscript.
J. F. Thompson contributed to the conception of the study, the design and structure of the model, advised on the presentation of results, and revised the manuscript.
Findings from this report were presented at the 6th International Sentinel Node Society meeting in Sydney, February 2008.