Context
Melanoma is the most deadly form of skin cancer and an important public health concern.
Given the substantial health burden associated with melanoma, it is important to examine
the economic costs associated with its treatment. The purpose of the current study
was to systematically review the literature on the direct medical care costs of melanoma.
Evidence acquisition
A systematic review was performed using multiple databases including MEDLINE, Embase,
CINAHL, and Econlit. Nineteen articles on the direct medical costs of melanoma were
identified.
Evidence synthesis
Detailed information on the study population, study country/setting, study perspective,
costing approach, disease severity (stage), and key study results were abstracted.
The overall costs of melanoma were examined as well as per-patient costs, costs by
phase of care, stage of diagnosis, and setting/type of care. Among studies examining
all stages of melanoma, annual treatment costs ranged from $44.9 million among Medicare
patients with existing cases to $932.5 million among newly diagnosed cases across
all age groups.
Conclusions
Melanoma leads to substantial direct medical care costs, with estimates varying widely
because of the heterogeneity across studies in terms of the study setting, populations
studied, costing approach, and study methods. Melanoma treatment costs varied by phase
of care and stage at diagnoses; costs were highest among patients diagnosed with late-stage
disease and in the initial and terminal phases of care. Aggregate treatment costs
were generally highest in the outpatient/office-based setting; per-patient/per-case
treatment costs were highest in the hospital inpatient setting. Given the substantial
costs of treating melanoma, public health strategies should include efforts to enhance
both primary prevention (reduction of ultraviolet light exposure) and secondary prevention
(earlier detection) of melanoma.
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References
- Incidence estimate of nonmelanoma skin cancer in the U.S., 2006.Arch Dermatol. 2010; 146: 283-287
- Nonmelanoma skin cancer in the U.S.: incidence.J Am Acad Dermatol. 1994; 30: 774-778
- U.S. cancer statistics: 1999–2008 incidence, WONDER online database.wonder.cdc.gov/cancer-v2008.htmlDate: 2011
- Underlying cause of death, 1999–2008, on CDC WONDER online database, released 2011.
- The epidemiology of skin cancer.Br J Dermatol. 2002; 146: 1-6
- Increasing burden of melanoma in the U.S..J Invest Dermatol. 2009; 129: 1666-1674
- Cutaneous malignant melanoma in Europe.Eur J Cancer. 2004; 40: 2355-2366
- The effect of sunscreen on melanoma risk.Dermatol Clin. 2002; 20: 601-606
- Trends in dermatology: melanoma incidence.Arch Dermatol. 2010; 146: 318
- Cost-of-illness studies—a primer.
- The health burden and economic costs of cutaneous melanoma mortality by race/ethnicity—U.S., 2000 to 2006.J Am Acad Dermatol. 2011; 65: S133-S143
- Years of potential life lost and indirect costs of melanoma and non-melanoma skin cancer: a systematic review of the literature.PharmacoEcon. 2011; 29: 863-874
- Health economic evaluation of non-melanoma skin cancer and actinic keratosis.PharmacoEcon. 2004; 22: 83-94
- The economic impact of non-melanoma skin cancer: a review.J Natl Compr Canc Netw. 2010; 8: 888
- Cost of care for elderly cancer patients in the U.S..J Natl Cancer Inst. 2008; 100: 630
- Economic burden of melanoma in the elderly population: population-based analysis of the Surveillance, Epidemiology, and End Results (SEER)-Medicare Data.Arch Dermatol. 2010; 146: 249
- Consumer price indexes: Bureau of Labor Statisitcs, 2010.
- Consumer price indices (CPI) for OECD countries and major non-member economies.
- Purchasing power parities (PPP).
- 2011 World economic outlook.
- An estimate of the annual direct cost of treating cutaneous melanoma.J Am Acad Dermatol. 1998; 38: 669-680
- Burden of illness associated with metastatic melanoma: an audit of 100 consecutive referral center cases.Cancer. 2001; 91: 1814-1821
- Skin cancer is among the most costly of all cancers to treat for the Medicare population.J Am Acad Dermatol. 2003; 48: 425-429
- The burden of skin diseases: 2004: a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology.J Am Acad Dermatol. 2006; 55: 490-500
- Melanoma costs: a dynamic model comparing estimated overall costs of various clinical stages.Dermatol Online J. 2009; 15: 1
- Direct economic burden of high-risk and metastatic melanoma in the elderly: evidence from the SEER-Medicare linked database.Appl Health Econ Health Policy. 2009; 7: 31-41
Mathers C, Penm R, Sanson-Fisher R, Campbell E. 1998. Health system costs of cancer in Australia 1993–94. Health and welfare expenditure series. Cat. no. HWE 8. Canberra: AIHW.
- The costs of skin cancer to New Zealand.Wellington School of Medicine, University of Otago, Wellington, New Zealand2000
- Skin diseases caused by ultraviolet radiation: the cost of illness.Int J Technol Assess Health Care. 2003; 19: 724-730
- Nationwide hospitalization costs of skin melanoma and non-melanoma skin cancer in Germany.J Eur Acad Dermatol Venereol. 2008; 22: 65-72
- The economic burden of melanoma in France: assessing healthcare use in a hospital setting.Melanoma Res. 2008; 18: 40-46
- Societal cost of skin cancer in Sweden in 2005.Acta Derm Venereol. 2008; 88: 467-473
- An estimate of the cost of treating mlanoma disease in the state of Sao Paulo-Brazil.An Bras Dermatol. 2009; 84: 237-243
- Descriptive study of the costs of diagnosis and treatment of cutaneous melanoma.Actas Dermosifiliogr. 2009; 100: 785-791
- Cost of skin cancer in England.Eur J Health Econ. 2009; 10: 267-273
- The costs of skin cancer to New Zealand.Wellington School of Medicine, University of Otago, Wellington, New Zealand2009
- Costs of the detection of metastases and follow-up examinations in cutaneous melanoma.Melanoma Res. 2009; 19: 50-57
- Use of indoor tanning devices by high school students in the U.S., 2009.Prev Chronic Dis. 2011; 8: A116
- Use of indoor tanning devices by adults—U.S., 2010.MMWR Morb Mortal Wkly Rep. 2012; 61: 323-326
- Estimation of avoidable skin cancers and cost-savings to government associated with regulation of the solarium industry in Australia.Health Policy. 2009; 89: 303-311
- Melanoma survival in the U.S., 1992 to 2005.J Am Acad Dermatol. 2011; 65: S78-S86
- Cancer treatment cost in the U.S..Cancer. 2010; 116: 3477-3484
- Ambulatory care for cancer in the U.S.: results from two national surveys comparing visits to physicians' offices and hospital outpatient departments.J Natl Med Assoc. 2007; 99: 1350
- Melanoma reporting to central cancer registries by U.S. dermatologists: an analysis of the persistent knowledge and practice gap.J Am Acad Dermatol. 2011; 65: S124-S132
- Clinical Practice Guidelines for the Management of Melanoma in Australia and New Zealand.Cancer Council Australia and Australian Cancer Network, Sydney and New Zealand Guidleines Group, Wellington, New Zealand2008
- Screening for skin cancer.Agency for Healthcare Research and Quality, Rockville MD2009
- Screening for malignant melanoma: a cost-effectiveness analysis.J Am Acad Dermatol. 1999; 41: 738-745
- Screening for melanoma by primary health care physicians: a cost-effectiveness analysis.J Med Screen. 1996; 3: 47-53
- Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation: a systematic review.Am J Prev Med. 2004; 27: 422-466
- Behavioral counseling to prevent skin cancer: a systematic review for the U.S. Preventive Services Task Force.Ann Intern Med. 2011; 154: 190
- Economic evaluation of the U.S. Environmental Protection Agency's SunWise program: sun protection education for young children.Pediatrics. 2008; 121: e1074-e1084
- Economic evaluation of skin cancer prevention in Australia.Prev Med. 2009; 49: 449-453
- The pathogenesis of melanoma induced by ultraviolet radiation.N Engl J Med. 1999; 340: 1341-1348
- The epidemiology of UV induced skin cancer.J Photochem Photobiol B. 2001; 63: 8-18
- Indoor tanning and risk of melanoma: a case-control study in a highly exposed population.Cancer Epidemiol Biomarkers Prev. 2010; 19: 1557
- The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: a systematic review.Int J Cancer. 2007; 120: 1116-1122
- The indoor UV tanning industry: a review of skin cancer risk, health benefit claims, and regulation.J Am Acad Dermatol. 2005; 53: 1038-1044
- Artificial tanning sunbeds: risk and guidance.
- Indoor tanning use among adolescents in the U.S., 1998 to 2004.Cancer. 2009; 115: 190-198
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