Economic burden of melanoma in three European countries
A retrospective observational study
Kontoudis, I., Harries, M., Mohr, P., Grange, F., Ehness, R., Benjamin, L., Siakpere, O., Barth, J., Stapelkamp, C., Pfersch, S., McLeod, L., Kaye, J., & Wolowacz, S. (2014). Economic burden of melanoma in three European countries: A retrospective observational study. Value in Health, 17(7), A626. https://doi.org/10.1016/j.jval.2014.08.2227
OBJECTIVES: To estimate cost-of-illness data associated with treatment of patients with stage IIIB/IIIC melanoma with macroscopic lymph node involvement in France, Germany and the United Kingdom (UK), whose primary melanoma and regional lymph node metastases had been completely resected.
METHODS: This retrospective observational study enrolled patients aged >=18 years, first diagnosed between 1 January 2009 and 31 December 2011. Data were extracted from medical records and via patient survey. Costs were calculated in Euros (France, Germany) or pound sterling (£) (UK) by collecting resource use and multiplying by country-specific unit costs. Costs were estimated from the health care provider perspective. National annual costs were estimated from study results and national disease prevalence estimates based on European cancer registry and other data.
RESULTS: 49 centres provided data on 558 patients (55.7% male, 58.2% aged less than 65 years at diagnosis, 53.6% stage IIIB disease). Mean follow-up was 27 months in France, 26 months in Germany and 22 months in the UK. Most patients received no adjuvant treatment in France (93.0%) and the UK (97.4%). Use of interferon in Germany was limited (high-dose 11.0%; intermediate-dose 4.9%; low-dose 15.2%; pegylated 1.8%). Mean total direct cost per patient during follow-up was EUR 23,582 in France, EUR 32,058 in Germany and £31,123 (EUR 37,348) in the UK. The largest cost drivers were melanoma treatment (mean EUR 14,004 France, EUR 21,269 Germany and £24,385 UK) and hospitalisation/emergency treatment (mean EUR 6,634 France, EUR 6,950 Germany and £2,827 UK). Total mean indirect costs per patient were EUR 129 in France, EUR 4,441 in Germany and £1,427 (EUR 1,712) in the UK. Preliminary estimates for annual national direct cost were EUR 13.1 million in France, EUR 30.2 million in Germany and £22.8 (EUR 27.6) million in the UK.
CONCLUSIONS: The economic burden of stage IIIB/IIIC melanoma with macroscopic lymph node involvement was substantial in all three countries. Indirect costs varied by country.