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Melanoma Screening Urged to Reduce Costs


 

Treatment for melanoma costs Medicare about $249 million annually, but effective prevention and early detection could reduce expenses by up to 60%, according to a new study.

Treatment expenses for each patient who died from melanoma totaled more than $28,000 on average from the time of diagnosis until death, according to Dr. Anne M. Seidler and her colleagues.

Policymakers should consider crafting guidelines for melanoma screening that reflect increased risks for patients older than age 65 years, they suggested.

Although relatively few elderly patients die of melanoma, per-patient expenses are particularly high in cases of advanced disease, noted Dr. Seidler, who is with the department of dermatology at Emory University in Atlanta, and her associates (Arch. Dermatol. 2010;146:249-56).

“The majority of consumption is attributable to advanced-stage disease and the terminal phase of treatment,” the investigators wrote. “If all patients were diagnosed and effectively treated in stage 0 or I, we estimate that the annual direct costs for the population 65 years or older would be between $99 million and $161 million, or 40% to 65% of their current value of $249 million.”

The researchers used Surveillance, Epidemiology, and End Results (SEER) data from 1,858 Medicare beneficiaries with a confirmed melanoma diagnosis and calculated cost by stage and treatment phase.

Average monthly per-patient melanoma charges were $2,194 during the initial 4 months of treatment. After this initial treatment phase, monthly costs fell to $902, but then increased to $3,933 if the cancer spread and became terminal, according to the investigators.

Total costs may be higher than found based on how much patients spent on copayments and deductibles.

A total of 263 patients died of melanoma during the 6 years studied. These patients lived an average of 26 months after diagnosis, and their care cost an average of $13,020 per year, the study reported.

Early-stage melanoma costs appeared similar to those of prostate cancer, while late-stage melanoma costs resembled those of colon cancer, which generally is more expensive to treat.

“The lack of definitive, effective therapy for melanoma, which may result in utilization of multiple chemotherapeutic agents in these later stages, likely drives up the costs,” Dr. Seidler and her associates noted.

The authors reported no financial conflicts of interest.

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