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Appl Health Econ Health Policy. 2018 Apr;16(2):235-242. doi: 10.1007/s40258-017-0368-0.

A National Budget Impact Analysis of a Specialised Surveillance Programme for Individuals at Very High Risk of Melanoma in Australia.

Author information

1
Sydney School of Public Health, The University of Sydney, The Lifehouse, Level 6-North, 119-143 Missenden Road, Camperdown, NSW, 2050, Australia. caroline.watts@sydney.edu.au.
2
Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia. caroline.watts@sydney.edu.au.
3
Sydney School of Public Health, The University of Sydney, The Lifehouse, Level 6-North, 119-143 Missenden Road, Camperdown, NSW, 2050, Australia.
4
Menzies Centre for Health Policy, The University of Sydney, Sydney, NSW, Australia.
5
Sydney Melanoma Diagnostic Centre, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
6
Dermatology Department, Royal Prince Alfred Hospital, The University of Sydney, Sydney, NSW, Australia.
7
Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia.
8
NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia.
9
Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia.

Abstract

BACKGROUND:

Specialised surveillance using total body photography and digital dermoscopy to monitor people at very high risk of developing a second or subsequent melanoma has been reported as cost effective.

OBJECTIVES:

We aimed to estimate the 5-year healthcare budget impact of providing specialised surveillance for people at very high risk of subsequent melanoma from the perspective of the Australian healthcare system.

METHODS:

A budget impact model was constructed to assess the costs of monitoring and potential savings compared with current routine care based on identification of patients at the time of a melanoma diagnosis. We used data from a published cost-effectiveness analysis of specialised surveillance, and Cancer Registry data, to estimate the patient population and healthcare costs for 2017-2021.

RESULTS:

When all eligible patients, estimated at 18% of patients with melanoma diagnosed annually in Australia, received specialised surveillance rather than routine care, the cumulative 5-year cost was estimated at $93.5 million Australian dollars ($AU) ($US 64 million) for specialised surveillance compared with $AU 120.7 million ($US 82.7 million) for routine care, delivering savings of $AU 27.2 million ($US 18.6 million). With a staggered introduction of 60% of eligible patients accessing surveillance in year 1, increasing to 90% in years 4 and 5, the cumulative cost over 5 years was estimated at $AU 98.1 million ($US 67.2 million), amounting to savings of $AU 22.6 million ($US 15.5 million) compared with routine care.

CONCLUSIONS:

Specialised melanoma surveillance is likely to provide substantial cost savings for the Australian healthcare system.

PMID:
29305821
DOI:
10.1007/s40258-017-0368-0

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