Ĭurrently, the definition of the diagnostic and therapeutic strategy for melanoma patients involves choosing between multiple alternative courses of action that impact cost structure and performance for patient survival. Furthermore, the development and dissemination of new imaging techniques, such as dermoscopy, ultrasound, magnetic resonance, and positron emission tomography have led to a more accurate diagnosis and staging of patients. A historical review shows a change in the size of resection margins, the introduction of the sentinel lymph node biopsy, and, since 2011, the approval of new and more effective systemic treatments. The landscape of cutaneous melanoma (CM) diagnosis, staging, prognosis, and treatment has been fundamentally altered in the past decade. We believe that cost-of-illness analysis from a strategic perspective could be of help in assessing executional costs and be used to support the change in structural costs required for long-term strategies related to the health value chain. The cost-of-illness study for CM has the potential to inform policymakers and decision-makers regarding the economic burden that melanoma impose on a society in terms of the use of health care services, assisting them in making projections of future health care costs and resource allocation decisions. Given the massive amount of resources spent by the SUS and HMO, significant efforts must be made to improve the health value chain to deliver the right mix of medical care goods and services using available resources. Overall, spending on advanced disease patients can be up to 34-fold (SUS) or 270-fold (HMO) higher than that required for the early-stage disease. HMO patient costs are approximately 10-fold and 90-fold more than a SUS patient in the early-stage and advanced disease, respectively.

ResultsĬM represents a critical financial burden in Brazil, and the cost of illness varied according to the health system and by stage at diagnosis. The structural cost was assessed qualitatively considering the health value chain in Brazil. The executional costs for the complete healthcare delivery cycle were investigated considering different disease stages and possible clinical course variations. The study considered the direct medical cost in a bottom-up analysis, using melanoma incidence, knowledge of the disease’s progression, and the overall survival rates. The cost-of-illness study for CM was conducted from the perspective of two health systems in Brazil: the public health system (Unified Health System, SUS) and the private health system (Health Management Organization, HMO).

While the benefits of new health resources are recognized, there is a distinct lack of accurate cost-of-illness information to aid healthcare decision makers. The landscape of cutaneous melanoma (CM) diagnosis, staging, prognosis, and treatment has undergone fundamental changes in the past decade.

Executional cost drivers examples