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按肿瘤分期划分的皮肤黑色素瘤成本:描述性分析

Cost of Cutaneous Melanoma by Tumor Stage: A Descriptive Analysis.

作者信息

Serra-Arbeloa P, Rabines-Juárez Á O, Álvarez-Ruiz M S, Guillén-Grima F

机构信息

Departamento de Ciencias de la Salud, Universidad Pública de Navarra, Pamplona, España; Departamento de Medicina Nuclear, Complejo Hospitalario de Navarra, Pamplona, España.

Applied Medical Reseach Program, Universidad de Navarra, Pamplona, España.

出版信息

Actas Dermosifiliogr. 2017 Apr;108(3):229-236. doi: 10.1016/j.ad.2016.09.010. Epub 2016 Nov 22.

Abstract

BACKGROUND AND OBJECTIVE

The basis for optimal resource allocation is an understanding of requirements during the diagnostic and treatment phases. Costs associated with the rising incidence of cutaneous melanoma are considerable. We undertook an up-to-date analysis of the cost of diagnosis, treatment, and follow-up according to tumor stage.

METHODS

We constructed descriptive tables following a theoretical model of direct costs based on amounts published in directives for the Spanish national health system and in international guidelines for managing cutaneous melanoma according to stage at diagnosis and clinical course. The tables allowed us to calculate the cost of treating individual patients as well as the expected cost for all patients with tumors in the same stage.

RESULTS

Individual patients would generate costs ranging from €1689 (for a stage I tumor) to €88, 268 (stage IV). The largest differences were between stages IA and IB-IIA and between stages III and IV. Costs differed greatly between patients with early-stage tumors and favorable outcomes and those with recurring tumors, which cost 50-fold more in the first year and 20-fold more after 10 years of follow-up.

CONCLUSIONS

The high cost of diagnosing advanced-stage cutaneous melanoma calls attention to the need to promote primary prevention and early detection. Our findings provide the knowledge base for cost-effectiveness studies in this disease.

摘要

背景与目的

优化资源分配的基础是了解诊断和治疗阶段的需求。皮肤黑色素瘤发病率上升带来的成本相当可观。我们根据肿瘤分期对诊断、治疗及随访成本进行了最新分析。

方法

我们依据基于西班牙国家卫生系统指令及国际皮肤黑色素瘤管理指南中按诊断分期和临床病程公布的金额所构建的直接成本理论模型,编制了描述性表格。这些表格使我们能够计算治疗个体患者的成本以及同一分期所有肿瘤患者的预期成本。

结果

个体患者产生的成本从1689欧元(I期肿瘤)到88268欧元(IV期)不等。最大差异存在于IA期与IB - IIA期之间以及III期与IV期之间。早期肿瘤且预后良好的患者与复发肿瘤患者的成本差异极大,复发肿瘤患者在第一年的成本高出50倍,随访10年后高出20倍。

结论

晚期皮肤黑色素瘤的高诊断成本凸显了促进一级预防和早期检测的必要性。我们的研究结果为该疾病的成本效益研究提供了知识基础。

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