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美国黑色素瘤护理的边缘医疗支出。

Marginal health care expenditures for melanoma care in the United States.

机构信息

Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, Houston, TX.

The Prescription Drug Misuse Education and Research (PREMIER) Center, University of Houston, Houston, TX.

出版信息

J Manag Care Spec Pharm. 2024 Dec;30(12):1364-1374. doi: 10.18553/jmcp.2024.30.12.1364.

Abstract

BACKGROUND

The incidence of melanoma has increased significantly in the past few decades, posing a significant public health challenge. However, there is an evidence gap regarding the marginal costs of treating melanoma.

OBJECTIVE

To examine the marginal health care expenditures for melanoma compared with other nonskin cancers among US adults.

METHODS

This study examined individuals aged 18 years or older with melanoma, nonmelanoma skin cancer (NMSC), and other cancers from the 2011-2020 Medical Expenditure Panel Survey datasets. Direct health care expenditures involving hospital inpatient, outpatient, prescription medications, dental, vision, home health care, and other medical services for melanoma were analyzed using generalized linear models, and comparisons were made with expenditures for other types of cancers while adjusting for other patient characteristics.

RESULTS

There were 0.70 million individuals (95% CI = 0.61-0.78) diagnosed with melanoma annually. Total health care expenditures among individuals with melanoma, NMSC, and other cancers were $19,427, $13,744, and $23,741, respectively. A generally increasing trend of expenditure was observed over the years. Notably, office-based care (30.46%), inpatient services (28.78%), and prescription (18.27%) costs primarily accounted for the health care burden of patients with melanoma. Adjusted marginal total health care expenditures for melanoma were found to be lower ($-3,369.01 [95% CI = -$5,934.15 to -$803.85]) than other cancers but higher ($2,844.75 [95% CI = $2,204.77-$3,484.72]) compared with NMSC. Prescription expenditures were similar across the 3 cancer study groups.

CONCLUSIONS

This study found that adjusted marginal expenditures for melanoma were higher than those with NMSC but lower than other nonskin cancers, with office-based care and inpatient expenditures contributing to most of the expenditures. The findings suggest that concerted efforts are needed to control the primary cost drivers to reduce the associated burden of potentially preventable skin cancer like melanoma.

摘要

背景

在过去几十年中,黑色素瘤的发病率显著增加,这对公共健康构成了重大挑战。然而,关于治疗黑色素瘤的边际成本的证据存在差距。

目的

研究与美国成年人中的非皮肤癌相比,黑色素瘤的边际医疗保健支出。

方法

本研究使用广义线性模型分析了来自 2011-2020 年医疗支出面板调查数据集的年龄在 18 岁或以上的黑色素瘤、非黑色素瘤皮肤癌 (NMSC) 和其他癌症患者的直接医疗保健支出,并在调整其他患者特征的情况下,将这些支出与其他类型癌症的支出进行比较。

结果

每年有 70 万人(95%置信区间为 0.61-0.78)被诊断患有黑色素瘤。患有黑色素瘤、NMSC 和其他癌症的个体的总医疗保健支出分别为 19427 美元、13744 美元和 23741 美元。多年来,支出呈总体上升趋势。值得注意的是,门诊护理(30.46%)、住院服务(28.78%)和处方(18.27%)费用主要构成了黑色素瘤患者的医疗保健负担。与其他癌症相比,黑色素瘤的调整边际总医疗保健支出较低(-3369.01 美元[95%置信区间=-5934.15 美元至-803.85 美元]),但高于 NMSC(2844.75 美元[95%置信区间=2204.77 美元至 3484.72 美元])。3 组癌症的处方支出相似。

结论

本研究发现,黑色素瘤的调整边际支出高于 NMSC,但低于其他非皮肤癌,门诊护理和住院支出是支出的主要驱动因素。研究结果表明,需要共同努力控制主要成本驱动因素,以减轻黑色素瘤等潜在可预防皮肤癌的相关负担。

相似文献

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Marginal health care expenditures for melanoma care in the United States.美国黑色素瘤护理的边缘医疗支出。
J Manag Care Spec Pharm. 2024 Dec;30(12):1364-1374. doi: 10.18553/jmcp.2024.30.12.1364.

本文引用的文献

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New Approaches to Targeted Therapy in Melanoma.黑色素瘤靶向治疗的新方法
Cancers (Basel). 2023 Jun 17;15(12):3224. doi: 10.3390/cancers15123224.
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Epidemiology of Melanoma.黑色素瘤流行病学。
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Immunotherapy for Non-melanoma Skin Cancer.非黑色素瘤皮肤癌的免疫疗法。
Curr Oncol Rep. 2021 Aug 27;23(11):125. doi: 10.1007/s11912-021-01120-z.

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