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.
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Change history
12 September 2017
The last word in the first paragraph which previously read AU$25 million should read 25 million as this relates to population size.
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Authors and Affiliations
Contributions
TE contributed to model development, conceptualisation, data analysis, modelling, writing and editing. CO and DW contributed to model conceptualisation, melanoma knowledge and intellectual inputs. LG contributed to model conceptualisation, data analysis, writing and editing. All authors were involved in writing, editing and approved the final version.
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Ethics declarations
DW was supported by a Research Fellowship (APP1058522) from the National Health and Medical Research Council of Australia (NHMRC). This work was supported by Program Grants (552429, 1073898) from the NHMRC. TE was supported by the NHMRC Centre for Research Excellence in Sun and Health (APP1001456). No conflicts of interest exist for TE, CO, DW or LG.
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An erratum to this article is available at https://doi.org/10.1007/s40258-017-0347-5.
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Elliott, T.M., Whiteman, D.C., Olsen, C.M. et al. Estimated Healthcare Costs of Melanoma in Australia Over 3 Years Post-Diagnosis. Appl Health Econ Health Policy 15, 805–816 (2017). https://doi.org/10.1007/s40258-017-0341-y
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DOI: https://doi.org/10.1007/s40258-017-0341-y