Gordon Louisa G, Leung William, Johns Richard, McNoe Bronwen, Lindsay Daniel, Merollini Katharina M D, Elliott Thomas M, Neale Rachel E, Olsen Catherine M, Pandeya Nirmala, Whiteman David C
Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia.
Cancer and Palliative Care Outcomes Centre and School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD 4059, Australia.
Int J Environ Res Public Health. 2022 Mar 8;19(6):3178. doi: 10.3390/ijerph19063178.
Australia and Aotearoa New Zealand have the highest incidence of melanoma and KC in the world. We undertook a cost-of-illness analysis using Markov decision-analytic models separately for melanoma and keratinocyte skin cancer (KC) for each country. Using clinical pathways, the probabilities and unit costs of each health service and medicine for skin cancer management were applied. We estimated mean costs and 95% uncertainty intervals (95% UI) using Monte Carlo simulation. In Australia, the mean first-year costs of melanoma per patient ranged from AU$644 (95%UI: $642, $647) for melanoma to AU$100,725 (95%UI: $84,288, $119,070) for unresectable stage III/IV disease. Australian-wide direct costs to the Government for newly diagnosed patients with melanoma were AU$397.9 m and AU$426.2 m for KCs, a total of AU$824.0 m. The mean costs per patient for melanoma ranged from NZ$1450 (95%UI: $1445, $1456) for melanoma to NZ$77,828 (95%UI $62,525, $94,718) for unresectable stage III/IV disease. The estimated total cost to New Zealand in 2021 for new patients with melanoma was NZ$51.2 m, and for KCs, was NZ$129.4 m, with a total combined cost of NZ$180.5 m. These up-to-date national healthcare costs of melanoma and KC in Australia and New Zealand accentuate the savings potential of successful prevention strategies for skin cancer.
澳大利亚和新西兰的黑素瘤及皮肤基底细胞癌发病率位居全球之首。我们分别针对每个国家，运用马尔可夫决策分析模型对黑素瘤和皮肤基底细胞癌进行了疾病成本分析。通过临床路径，确定了皮肤癌治疗中各项医疗服务及药物的概率和单位成本。我们使用蒙特卡洛模拟法估算了平均成本及95%的不确定性区间（95%UI）。在澳大利亚，每位黑素瘤患者的首年平均成本从黑素瘤的644澳元（95%UI：642澳元，647澳元）到不可切除的III/IV期疾病的100,725澳元（95%UI：84,288澳元，119,070澳元）不等。澳大利亚政府为新诊断的黑素瘤患者承担的直接成本为3.979亿澳元，皮肤基底细胞癌患者为4.262亿澳元，总计8.240亿澳元。每位黑素瘤患者的平均成本从黑素瘤的1450新西兰元（95%UI：1445新西兰元，1456新西兰元）到不可切除的III/IV期疾病的77,828新西兰元（95%UI：62,525新西兰元，94,718新西兰元）不等。2021年，新西兰新诊断黑素瘤患者的估计总成本为5120万新西兰元，皮肤基底细胞癌患者为1.294亿新西兰元，总计1.805亿新西兰元。澳大利亚和新西兰最新的黑素瘤及皮肤基底细胞癌国家医疗成本凸显了成功预防皮肤癌策略的潜在节省效益。
