ECONOMIC-EVALUATION OF AN EDUCATIONAL CAMPAIGN FOR EARLY DIAGNOSIS OFCUTANEOUS MELANOMA

Public educational campaigns for the early diagnosis of cutaneous mela noma are considered an effective approach in the prevention of this di sease, since they increase the number of cases detected early and cons equently lengthen patients' life expectancy. We performed an economic evaluation of such a campaign in Bergamo, Italy, in order to quantify its costs and consequences. We used cost-effectiveness analysis to com pare the costs and effects of the campaign with those of the 'do nothi ng' option. The analysis was performed from the perspective of the Ita lian National Health Service [the Servizio Sanitario Nazionale (SSN)]. Accordingly, only direct costs related to publicly financed healthcar e services were considered. No indirect costs or benefits were conside red because they are not relevant to the SSN. Incremental analysis was used to obtain results in terms of additional costs per life-year sav ed (LYS). Overall LYS were quantified by comparing the survival curves for 4 subgroups of patients with different lesional thicknesses at di agnosis (<0.76mm, 0.76 to 1.50mm, 1.51 to 3.00mm and >3.00mm). All cos ts were estimated in 1993 Italian lire (L). Overall effectiveness amou nted to 233.49 LYS. Using a 5% discount rate, the value of effectivene ss was 171.3 LYS. The total cost of the educational campaign (i.e. the sum of the organisational and 'induced' costs minus the costs saved) was estimated at L817 million (approximate 1993 exchange rare $US 1 = L1573), and 1,905 million after discounting at a rate of 5%. Thus, usi ng discounted cost and effectiveness data, the cost of the educational campaign was L5.28 million per LYS.