Gwadry-Sridhar F, Nikan S, Hamou A, Seung S J, Petrella T, Joshua A M, Ernst S, Mittmann N
University of Western Ontario, London.
Pulse Infoframe, London.
Curr Oncol. 2017 Jun;24(3):168-175. doi: 10.3747/co.24.3432. Epub 2017 Jun 27.
The use and detailed costs of services provided for people with advanced melanoma (amel) are not well known. We conducted an analysis to determine the use of health care services and the associated costs delineated by relevant attributable costs, which we defined for subjects in the province of Ontario.
Through the Ontario Cancer Data Linkage Project, a cohort of amel patients with diagnoses between 31 August 2005 and 2012 (follow-up to 2013) and with valid (9th revision, Clinical Modification) 172 codes and histology codes was identified. A cohort of individuals with amel having a combination of at least 1 palliative, 1 medical oncology, and 1 hospitalization code was generated. The health system services used by this population were clustered into hospitalization, palliation, physician medical visits, medication, homecare, laboratory, diagnostics, and other resources. Overall rates of use and disaggregated costs were determined by phase of care for the entire cohort.
The mean age for the 2748 individuals in the cohort was 67 years. The greater proportion of the patients were men (65.6%) and were more than 65 years of age (>50%). In this advanced cohort, fewer than 45% of patients were alive 3 years after the malignant melanoma diagnosis. The average annual cost per patient over the time horizon was $6,551. At $15,830, year 1 after diagnosis was the most expensive, followed by year 2, at $8,166.
Our data provide a baseline for the costs associated with amel treatment. Future studies will include newer agents and comparative effectiveness research for personalized therapies.
为晚期黑色素瘤患者提供的服务使用情况及详细成本尚不清楚。我们进行了一项分析，以确定医疗服务的使用情况以及由相关可归因成本界定的相关成本，这些成本是我们为安大略省的患者定义的。
通过安大略癌症数据链接项目，确定了一组在2005年8月31日至2012年期间被诊断为晚期黑色素瘤（随访至2013年）且具有有效的（第9版，临床修订版）172码和组织学编码的患者。生成了一组至少有1个姑息治疗、1个医学肿瘤学和1个住院编码组合的晚期黑色素瘤患者。该人群使用的卫生系统服务被归类为住院、姑息治疗、医生门诊、药物治疗、家庭护理、实验室检查、诊断和其他资源。通过对整个队列的护理阶段确定总体使用率和分类成本。
该队列中2748名患者的平均年龄为67岁。患者中男性比例更高（65.6%），且年龄超过65岁（>50%）。在这个晚期队列中，不到45%的患者在恶性黑色素瘤诊断后3年仍存活。在整个观察期内，每位患者的平均年度成本为6551美元。诊断后的第1年成本最高，为15830美元，其次是第2年，为8166美元。
我们的数据为晚期黑色素瘤治疗相关成本提供了一个基线。未来的研究将包括更新的药物和个性化治疗的比较有效性研究。
