Study finds melanoma treatment costs have increased, but so has survival

Key takeaways:

• In comparing the period between 2007 and 2012 with 2018 and 2019, systemic therapy cost increased sixfold to ninefold.
• The 3-year overall survival rate increased from 65.8% to 74.2% in the same time frame.

While the adoption of immunotherapies and targeted systemic therapies for the treatment of melanoma has increased overall survival in patients, it has also significantly increased health care costs, according to a study.

“Health care costs for cancer treatment are escalating, with approximately $173 billion in the U.S. and more than $7 billion in Canada during 2020 alone,” Sarah B. Bateni, MD, MAS, of the Odette Cancer Center, Sunnybrook Health Sciences Center in Toronto, and colleagues wrote. “Because melanoma is the eighth most common cancer in Canada and the fifth most common in the U.S., it represents a source of significant health care expenditure.”

To examine the changes in health care costs, overall survival and time toxicity associated with melanoma treatment, Bateni and her colleagues conducted a cohort study comprised of 731 patients aged 20 years and older with stages II through IV cutaneous melanoma in Ontario, Canada.

Results showed that patients spent more on melanoma health care, including systemic therapy, during 2018 to 2019 compared with 2007 to 2012 (mean cost, $47,886 vs. $33,347).

Healthcare related to stage III and stage IV disease represented the largest gap between the two time periods. The 2007 to 2012 patients spent $46,511 on stage III treatment, whereas the 2018 to 2019 patients spent $67,108. Similarly for stage IV treatment, the mean cost for 2007 to 2012 patients was $47,739 compared with $117,450 for the 2018 to 2019 patients.

Systemic treatment for melanoma was also widely more expensive in 2018 to 2019 compared with 2007 to 2012 for stage II ($40,823 vs. $10,309, respectively), stage III ($55,699 vs. $9,764) and stage IV ($79,358 vs. $9,318). For stage III and stage IV patients, this represents a sixfold to ninefold increase in health care costs per person, according to the study.

Time toxicity was similar between generations except for patients with stage IV disease. These patients from 2018 to 2019 reported physical contact with the health care system an average of 58.7 days a year, whereas those from 2007 to 2012 reported an average of 44.2 days.

However, the survival rate among patients from 2018 to 2019 was higher than in 2007 to 2012 (3-year survival rate, 74.2% vs. 65.8%; HR = 0.72; 95% CI, 0.61-0.85). This improvement in survival rates can be attributed to the adoption of immunotherapy and targeted therapies, according to the study.

“These results highlight the value trade-off of these new effective systemic therapies in which there is a greater economic burden to the health care system and time burden to patients with stage IV disease but with associated improvements in patient survival,” Bateni and colleagues wrote.

According to the authors, the key takeaway is that the rising economic burden in melanoma treatment for patients highlights the importance of early disease detection.