Merck & Co., Inc., Rahway, NJ, USA.
Analysis Group, Inc, Boston, MA, USA.
J Med Econ. 2024 Jan-Dec;27(1):1279-1292. doi: 10.1080/13696998.2024.2403283. Epub 2024 Oct 2.
To compare healthcare resource utilization (HRU) and costs between patients with or without melanoma recurrence and between patients with distant or locoregional melanoma recurrence.
Patients aged ≥65 years with completely resected, stage IIB/IIC or III melanoma were identified from Surveillance, Epidemiology, and End Results-Medicare data and stratified based on whether they experienced a recurrence, and whether it was distant or locoregional (separately for each stage). The index date was the date of recurrence (recurrence group) or a randomly assigned date (non-recurrence group). Patients in the recurrence and non-recurrence groups were propensity score-matched 1:1 based on patient characteristics; HRU and healthcare costs were compared between the 2 groups and between patients with distant or locoregional recurrence during the ≤24 months following index.
After matching, 507 pairs of patients with recurrent or non-recurrent stage IIB/IIC melanoma (236 patients with distant recurrence, 271 with locoregional) and 141 pairs of patients with recurrent or non-recurrent stage III melanoma (50 patients with distant recurrence, 91 with locoregional) were included. During the first year following recurrence, unadjusted HRU was generally higher in patients with versus without recurrence and patients with distant versus locoregional recurrence among both stage IIB/IIC and III cohorts. Patients who experienced recurrence incurred $6,474 (stage IIB/IIC) or $6,112 (stage III) per patient per month (PPPM) more in unadjusted, all-cause, total healthcare costs than patients without recurrence (both < 0.001). Patients with distant recurrence incurred $7,292 (stage IIB/IIC) or $5,436 (stage III) PPPM more in unadjusted, all-cause, total healthcare costs than patients with locoregional recurrence (both < 0.05).
Melanoma recurrence was identified using a claims-based algorithm.
Economic burden is higher in patients with versus without melanoma recurrence and patients with distant versus locoregional recurrence. There is a high unmet need for adjuvant therapies that may help to prevent or delay recurrence.
比较有或无黑色素瘤复发患者以及远处或局部区域复发患者的医疗资源利用（HRU）和成本。
从监测、流行病学和结果-医疗保险数据中确定年龄≥65 岁、完全切除的 IIB/IIC 或 III 期黑色素瘤患者，并根据是否经历复发以及是远处还是局部区域复发进行分层（分别针对每个阶段）。索引日期是复发日期（复发组）或随机指定日期（非复发组）。在患者特征的基础上，对复发组和非复发组患者进行 1:1 的倾向评分匹配；比较两组患者以及索引后≤24 个月内远处或局部区域复发患者之间的 HRU 和医疗保健成本。
匹配后，纳入 507 对有或无 IIB/IIC 期复发的黑色素瘤患者（远处复发 236 例，局部区域复发 271 例）和 141 对有或无 III 期复发的黑色素瘤患者（远处复发 50 例，局部区域复发 91 例）。在复发后的第一年，IIB/IIC 和 III 队列中，与无复发患者相比，有复发患者和远处复发患者的未经调整的 HRU 通常更高。与无复发患者相比，有复发患者的未经调整的、全因、总医疗保健费用每月多支出 6474 美元（IIB/IIC 期）或 6112 美元（III 期）/患者（均<0.001）。与局部区域复发患者相比，远处复发患者的未经调整的、全因、总医疗保健费用每月多支出 7292 美元（IIB/IIC 期）或 5436 美元（III 期）（均<0.05）。
黑色素瘤复发是通过基于索赔的算法确定的。
与无黑色素瘤复发患者相比，有黑色素瘤复发患者以及远处复发患者与局部区域复发患者的经济负担更高。需要更多的辅助治疗方法来预防或延迟复发，但目前尚未满足这一需求。
