Abstract 874P
Background
This cost-of-illness study analyses the socio-economic burden of malignant melanoma survivorship for the ten years following initial treatment in Germany during 2000, 2010, and 2020.
Methods
We developed a patient-level micro-costing approach that considers direct and indirect medical expenses resulting from cancer follow-ups to estimate the economic spending on malignant melanoma survivorship. The frequency of recommended follow-up procedures was obtained from German guidelines. Direct medical expenses were derived from literature and official scales of tariffs, whilst indirect expenses were estimated based on opportunity costs. Follow-up-related costs were estimated in a cohort of 1,000 patients. Expenditure arising for patients, healthcare providers (including physicians and nurses), and insurers were combined to calculate societal costs.
Results
Mean ten-year follow-up costs for the society amounted to 5,081€ (95% CI: 4,164-6,151) for stage IA, 8,957€ (95% CI: 7,642-10,539) for stage IB-IIB, and 12,434€ (95%CI: 10,843-14,242) for stage IIC-IV malignant melanoma survivors in 2020. Total societal expenditure surged by +17% from 2000 to 2020 (p<0.001). Costs were shifted from patients and physicians to insurers, who reduced their reimbursement rates from 29% in 2000 to 21% in 2000. Resources consumption comprised physician-patient consultations and self-examinations (65%), blood tests (5%), diagnostic imaging (9%), and travel expenditure (21%). Expenses mainly arose during the first two years after initial treatment, which entailed more frequent and resource-intensive consultations (years 1-2: 37%, years 3-5: 34%, years 6-10: 29%).
Conclusions
The introduction of general practitioner-led screenings, improved diagnostics, and novel anti-cancer medicines decreased cancer mortality rates; ultimately leading to a surge in the population of cancer survivors. This study highlights the rising socio-economic burden of malignant melanoma survivorship. Policy makers should explore risk-stratified follow-ups to provide more personalized care for survivors. Individualized, evidence-based, and insurance-covered follow-ups are required to early detect side-effects, metastasis, and secondary malignancies.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.