TITLE:
Medical Costs by Disease Stage in Medicare Patients with Metastatic Melanoma
AUTHORS:
Amanda M. Farr, Zhongyun Zhao, Xue Song, Beth Barber, Boris Ivanov, Marilyn Novich
KEYWORDS:
Melanoma, Healthcare Costs, Disease Stage, Medicare
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.8 No.11,
November
8,
2017
ABSTRACT: Background: Melanoma is a rare but serious skin cancer that is
responsible for >90% of skin cancer-related deaths. This retrospective data
analysis quantifies the direct cost of medical care by disease stage at
diagnosis for patients with metastatic melanoma. Methods: The Surveillance,
Epidemiology, and End Results (SEER)-Medicare database was queried for patients diagnosed between 2004-2009 with stage IIIB/C and stage IV (M1a, M1b, M1c) melanoma.
The primary outcome was overall medical utilization and associated costs from
diagnosis to death, the end of Medicare enrolment, or 12/31/2010. Results are
stratified by disease stage at diagnosis and presented as per-patient per-month
(PPPM) costs. Results: Of the 1263 patients meeting the
study criteria (mean age: 75 years; 64% male, 92% white, mean duration of
follow up: 37.5 months), 66.6% were diagnosed at stage IIIB/C and 33.4% at stage IV. Cost of care increased with
disease stage. Total PPPM costs ranged from $1966 for patients diagnosed with stage IIIB to $4585 among patients
diagnosed with stage M1c. Outpatient costs accounted 48.9% of total medical
costs among stage IIIB patients, and 38.7% of total medical costs for stage M1c
patients. Inpatient costs accounted for 37.1% (stage M1b) - 40.9% (stage M1c)
of total medical costs. Conclusions: Healthcare costs for treating
patients with metastatic melanoma increase by disease stage. The cost of care
was more than double among patients with late stage compared to those with
early stage. Treatments demonstrating ability to prevent disease progression
from early stage to late stage may confer an economic benefit among other
clinical advantages.