AN ESTIMATE OF THE ANNUAL DIRECT COST OF TREATING CUTANEOUS MELANOMA

Background: Although the survival benefits of early stage melanoma hav e been clearly documented, the potential economic impact of early vers us late stage disease has not been assessed. Objective: Our purpose wa s to estimate the annual direct cost of diagnosing and treating melano ma, based on the number of projected cases of melanoma entering each s tage in 1997. Methods: A model was constructed with assumptions derive d from the literature and clinical experience at the Massachusetts Gen eral Hospital Melanoma Center and the Boston University Medical Center . Cost estimates were based on 1997 Boston area Medicare reimbursement s. Results: The annual direct cost of treating newly diagnosed melanom a in 1997 was estimated to be $563 million. Stage I and Il disease eac h comprised about 5% of the total cost; stage III and stage IV disease consumed 34% and 55% of the total cost, respective ly. About 90% of t he total annual direct cost of treating melanoma in 1997 was attributa ble to less than 20% of patients (those patients with advanced disease , that is, stage III and stage TV). Conclusion: In addition to the pot ential survival advantages, aggressive primary prevention through sun protection and intensive screening to enhance earlier detection should reduce the economic burden of melanoma care.