Skip to main content
Top
Published in: Applied Health Economics and Health Policy 6/2017

01-12-2017 | Original Research Article

Estimated Healthcare Costs of Melanoma in Australia Over 3 Years Post-Diagnosis

Authors: Thomas M. Elliott, David C. Whiteman, Catherine M. Olsen, Louisa G. Gordon

Published in: Applied Health Economics and Health Policy | Issue 6/2017

Login to get access

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.
Literature
3.
go back to reference Gordon LG, Rowell D. Health system costs of skin cancer and cost-effectiveness of skin cancer prevention and screening: a systematic review. Eur J Cancer Prev. 2015;24(2):141–9.CrossRefPubMed Gordon LG, Rowell D. Health system costs of skin cancer and cost-effectiveness of skin cancer prevention and screening: a systematic review. Eur J Cancer Prev. 2015;24(2):141–9.CrossRefPubMed
4.
go back to reference Maio M, Grob JJ, Aamdal S, Bondarenko I, Robert C, Thomas L, et al. Five-year survival rates for treatment-naive patients with advanced melanoma who received ipilimumab plus dacarbazine in a phase III trial. J Clin Oncol. 2015;33(10):1191–6. doi:10.1200/JCO.2014.56.6018.CrossRefPubMed Maio M, Grob JJ, Aamdal S, Bondarenko I, Robert C, Thomas L, et al. Five-year survival rates for treatment-naive patients with advanced melanoma who received ipilimumab plus dacarbazine in a phase III trial. J Clin Oncol. 2015;33(10):1191–6. doi:10.​1200/​JCO.​2014.​56.​6018.CrossRefPubMed
5.
go back to reference Gedye C, Boyle F. Optimising treatment for Australian melanoma patients can save taxpayers millions of dollars annually. Med J Aust. 2015;202(3):i.CrossRef Gedye C, Boyle F. Optimising treatment for Australian melanoma patients can save taxpayers millions of dollars annually. Med J Aust. 2015;202(3):i.CrossRef
8.
9.
go back to reference Tsao H, Rogers GS, Sober AJ. An estimate of the annual direct cost of treating cutaneous melanoma. J Am Acad Dermatol. 1998;38(5 Pt 1):669–80.CrossRefPubMed Tsao H, Rogers GS, Sober AJ. An estimate of the annual direct cost of treating cutaneous melanoma. J Am Acad Dermatol. 1998;38(5 Pt 1):669–80.CrossRefPubMed
10.
go back to reference Souza RJ, Mattedi AP, Rezende ML, Correa Mde P, Duarte EM. An estimate of the cost of treating melanoma disease in the state of Sao Paulo–Brazil. An Bras Dermatol. 2009;84(3):237–43.CrossRefPubMed Souza RJ, Mattedi AP, Rezende ML, Correa Mde P, Duarte EM. An estimate of the cost of treating melanoma disease in the state of Sao Paulo–Brazil. An Bras Dermatol. 2009;84(3):237–43.CrossRefPubMed
12.
15.
16.
go back to reference Wilkinson D, Askew DA, Dixon A. Skin cancer clinics in Australia: workload profile and performance indicators from an analysis of billing data. Med J Aust. 2006;184(4):162–4.PubMed Wilkinson D, Askew DA, Dixon A. Skin cancer clinics in Australia: workload profile and performance indicators from an analysis of billing data. Med J Aust. 2006;184(4):162–4.PubMed
18.
go back to reference Australian Cancer Network Melanoma Guidelines Revision Working Party. Clinical practice guidelines for the management of melanoma in Australia and New Zealand. Wellington: Sydney and New Zealand Guidelines Group; 2008. Australian Cancer Network Melanoma Guidelines Revision Working Party. Clinical practice guidelines for the management of melanoma in Australia and New Zealand. Wellington: Sydney and New Zealand Guidelines Group; 2008.
20.
go back to reference Niebling MG, Haydu LE, Karim RZ, Thompson JF, Scolyer RA. Pathology review significantly affects diagnosis and treatment of melanoma patients: an analysis of 5011 patients treated at a melanoma treatment center. Ann Surg Oncol. 2014;21(7):2245–51. doi:10.1245/s10434-014-3682-x.CrossRefPubMed Niebling MG, Haydu LE, Karim RZ, Thompson JF, Scolyer RA. Pathology review significantly affects diagnosis and treatment of melanoma patients: an analysis of 5011 patients treated at a melanoma treatment center. Ann Surg Oncol. 2014;21(7):2245–51. doi:10.​1245/​s10434-014-3682-x.CrossRefPubMed
21.
go back to reference Baade P, Meng X, Youlden D, Aitken J, Youl P. Time trends and latitudinal differences in melanoma thickness distribution in Australia, 1990–2006. Int J Cancer. 2012;130(1):170–8. doi:10.1002/ijc.25996.CrossRefPubMed Baade P, Meng X, Youlden D, Aitken J, Youl P. Time trends and latitudinal differences in melanoma thickness distribution in Australia, 1990–2006. Int J Cancer. 2012;130(1):170–8. doi:10.​1002/​ijc.​25996.CrossRefPubMed
22.
go back to reference Tracey E, Kerr T, Dobrovic A, Currow D. Cancer. In: NSW: Incidence and Mortality Report 2008. Sydney: Cancer Institute NSW; 2010. Tracey E, Kerr T, Dobrovic A, Currow D. Cancer. In: NSW: Incidence and Mortality Report 2008. Sydney: Cancer Institute NSW; 2010.
24.
go back to reference Long GV, Flaherty KT, Stroyakovskiy D, Gogas H, Levchenko E, de Braud F, et al. Dabrafenib plus trametinib versus dabrafenib monotherapy in patients with metastatic BRAF V600E/K-mutant melanoma: long-term survival and safety analysis of a phase 3 study. Ann Oncol Off J Eur Soc Med Oncol. 2017;. doi:10.1093/annonc/mdx176. Long GV, Flaherty KT, Stroyakovskiy D, Gogas H, Levchenko E, de Braud F, et al. Dabrafenib plus trametinib versus dabrafenib monotherapy in patients with metastatic BRAF V600E/K-mutant melanoma: long-term survival and safety analysis of a phase 3 study. Ann Oncol Off J Eur Soc Med Oncol. 2017;. doi:10.​1093/​annonc/​mdx176.
26.
go back to reference Robert CLG, Brady B, et al. Nivolumab in previously untreated melanoma without BRAF mutation. N Engl J Med. 2015;372(4):311–9.CrossRef Robert CLG, Brady B, et al. Nivolumab in previously untreated melanoma without BRAF mutation. N Engl J Med. 2015;372(4):311–9.CrossRef
30.
go back to reference Australian Institute of Health and Welfare. Admitted patient care 2013–14: Australian hospital statistics. Canberra: Commonwealth Government; 2015. Australian Institute of Health and Welfare. Admitted patient care 2013–14: Australian hospital statistics. Canberra: Commonwealth Government; 2015.
31.
go back to reference Australian Institute of Health and Welfare. Separation statistics by principal diagnosis in ICD-10-AM. Canberra: Commonwealth Government; 2013. Australian Institute of Health and Welfare. Separation statistics by principal diagnosis in ICD-10-AM. Canberra: Commonwealth Government; 2013.
33.
go back to reference Australian Institute of Health and Welfare & Australian Association for Cancer Registries. Cancer in Australia: an overview 2012. Canberra: Commonwealth Government; 2012. Australian Institute of Health and Welfare & Australian Association for Cancer Registries. Cancer in Australia: an overview 2012. Canberra: Commonwealth Government; 2012.
34.
go back to reference Olsen CMWL, Green AC, Bain CJ, Fritschi L, PAF Project, Neale RE, Whiteman DC. Cancers in Australia attributable to exposure to solar ultraviolet radiation and prevented by regular sunscreen use. Aust N Z J Public Health. 2015;39(5):471–6.CrossRefPubMedPubMedCentral Olsen CMWL, Green AC, Bain CJ, Fritschi L, PAF Project, Neale RE, Whiteman DC. Cancers in Australia attributable to exposure to solar ultraviolet radiation and prevented by regular sunscreen use. Aust N Z J Public Health. 2015;39(5):471–6.CrossRefPubMedPubMedCentral
36.
go back to reference Baade PD, Youl PH, Janda M, Whiteman DC, Del Mar CB, Aitken JF. Factors associated with the number of lesions excised for each skin cancer: a study of primary care physicians in Queensland, Australia. Arch Dermatol. 2008;144(11):1468–76. doi:10.1001/archderm.144.11.1468.CrossRefPubMed Baade PD, Youl PH, Janda M, Whiteman DC, Del Mar CB, Aitken JF. Factors associated with the number of lesions excised for each skin cancer: a study of primary care physicians in Queensland, Australia. Arch Dermatol. 2008;144(11):1468–76. doi:10.​1001/​archderm.​144.​11.​1468.CrossRefPubMed
37.
38.
go back to reference Youl PH, Baade PD, Janda M, Del Mar CB, Whiteman DC, Aitken JF. Diagnosing skin cancer in primary care: how do mainstream general practitioners compare with primary care skin cancer clinic doctors? Med J Aust. 2007;187(4):215–20.PubMed Youl PH, Baade PD, Janda M, Del Mar CB, Whiteman DC, Aitken JF. Diagnosing skin cancer in primary care: how do mainstream general practitioners compare with primary care skin cancer clinic doctors? Med J Aust. 2007;187(4):215–20.PubMed
39.
go back to reference Australian Institute of Health and Welfare. Health system expenditure on cancer and other neoplasms in Australia, 2008–09. Commonwealth Government. Canberra: AIHW; 2013. Australian Institute of Health and Welfare. Health system expenditure on cancer and other neoplasms in Australia, 2008–09. Commonwealth Government. Canberra: AIHW; 2013.
40.
go back to reference Australian Institute of Health and Welfare. Health system expenditures on cancer and other neoplasms in Australia, 2000–01. In: Health and Welfare Expenditure series no. 22. Canberra: Commonwealth Government; 2005. Australian Institute of Health and Welfare. Health system expenditures on cancer and other neoplasms in Australia, 2000–01. In: Health and Welfare Expenditure series no. 22. Canberra: Commonwealth Government; 2005.
42.
go back to reference Gaulin C, Sebaratnam DF, Fernandez-Penas P. Quality of life in non-melanoma skin cancer. Australas J Dermatol. 2015;56(1):70–6.CrossRefPubMed Gaulin C, Sebaratnam DF, Fernandez-Penas P. Quality of life in non-melanoma skin cancer. Australas J Dermatol. 2015;56(1):70–6.CrossRefPubMed
43.
go back to reference KPMG. Advanced Melanoma—the real cost of Australia’s national cancer: a report prepared for Melanoma Patients Australia. Sydney; 2014. KPMG. Advanced Melanoma—the real cost of Australia’s national cancer: a report prepared for Melanoma Patients Australia. Sydney; 2014.
44.
go back to reference Green AC, Marquart L, Clemens SL, Harper CM, O’Rourke PK. Frequency of sunburn in Queensland adults: still a burning issue. Med J Aust. 2013;198(8):431–4.CrossRefPubMed Green AC, Marquart L, Clemens SL, Harper CM, O’Rourke PK. Frequency of sunburn in Queensland adults: still a burning issue. Med J Aust. 2013;198(8):431–4.CrossRefPubMed
45.
go back to reference Gordon LG, Scuffham PA, van der Pols JC, McBride P, Williams GM, Green AC. Regular sunscreen use is a cost-effective approach to skin cancer prevention in subtropical settings. J Invest Dermatol. 2009;129(12):2766–71. doi:10.1038/jid.2009.141.CrossRefPubMed Gordon LG, Scuffham PA, van der Pols JC, McBride P, Williams GM, Green AC. Regular sunscreen use is a cost-effective approach to skin cancer prevention in subtropical settings. J Invest Dermatol. 2009;129(12):2766–71. doi:10.​1038/​jid.​2009.​141.CrossRefPubMed
46.
47.
go back to reference Australian Institute of Health and Welfare. Health expenditure Australia 2010–11. Canberra: Australian Institute of Health and Welfare; 2011. Australian Institute of Health and Welfare. Health expenditure Australia 2010–11. Canberra: Australian Institute of Health and Welfare; 2011.
48.
go back to reference The Organisation for Economic Co-operation and Development. What future for health spending? OECD Economics Department Policy Notes. 2013; No. 19. The Organisation for Economic Co-operation and Development. What future for health spending? OECD Economics Department Policy Notes. 2013; No. 19.
49.
go back to reference Whiteman DCGA, Olsen CM. The growing burden of melanoma: projections of incidence and counts in six susceptible populations to 2031. J Invest Dermatol. 2016;136(6):1161–71.CrossRefPubMed Whiteman DCGA, Olsen CM. The growing burden of melanoma: projections of incidence and counts in six susceptible populations to 2031. J Invest Dermatol. 2016;136(6):1161–71.CrossRefPubMed
50.
go back to reference Exxedine KMD, Mauger E, et al. Artificial and natural ultraviolet radiation exposure: beliefs and behaviour of 7200 French adults. Euro Acad Dermatol Venereol. 2008;22(2):186–94. Exxedine KMD, Mauger E, et al. Artificial and natural ultraviolet radiation exposure: beliefs and behaviour of 7200 French adults. Euro Acad Dermatol Venereol. 2008;22(2):186–94.
Metadata
Title
Estimated Healthcare Costs of Melanoma in Australia Over 3 Years Post-Diagnosis
Authors
Thomas M. Elliott
David C. Whiteman
Catherine M. Olsen
Louisa G. Gordon
Publication date
01-12-2017
Publisher
Springer International Publishing
Published in
Applied Health Economics and Health Policy / Issue 6/2017
Print ISSN: 1175-5652
Electronic ISSN: 1179-1896
DOI
https://doi.org/10.1007/s40258-017-0341-y

Other articles of this Issue 6/2017

Applied Health Economics and Health Policy 6/2017 Go to the issue

Acknowledgement to Referees

Acknowledgement to Referees