HEALTHCARE RESOURCE UTILIZATION (HRU) AND COST BURDEN IN NON-METASTATIC MELANOMA IN THE MODERN TREATMENT ERA: A SURVEILLANCE, EPIDEMIOLOGY, AND END RESULTS (SEER)-MEDICARE ANALYSIS
Author(s)
Leah B. Sansbury, PhD, MSPH, FISPE1, Marianne Cunnington, MPhil, PhD2, Angela Lax, MPH3, Adina Zhang, MS4, Mei Sheng Duh, MPH, ScD4, Maral DerSarkissian, PhD5, Vanja Sikirica, MPH, PharmD1, Eden Ma, MS4, Alexandra Barry, MS4, Ahmad A. Tarhini, MD, PhD6;
1Moderna, Inc., Cambridge, MA, USA, 2Analysis Group Ltd, London, United Kingdom, 3Analysis Group, Inc., Denver, CO, USA, 4Analysis Group, Inc., Boston, MA, USA, 5Analysis Group, Inc., Los Angeles, CA, USA, 6UPCI; Department of Hematology/Oncology, Pittsburgh, PA, USA
1Moderna, Inc., Cambridge, MA, USA, 2Analysis Group Ltd, London, United Kingdom, 3Analysis Group, Inc., Denver, CO, USA, 4Analysis Group, Inc., Boston, MA, USA, 5Analysis Group, Inc., Los Angeles, CA, USA, 6UPCI; Department of Hematology/Oncology, Pittsburgh, PA, USA
OBJECTIVES: Melanoma remains the most serious form of skin cancer. This study described characteristics, HRU, and costs among patients in the United States with non-metastatic melanoma by stage and among those treated with newer immune checkpoint inhibitors (ICIs).
METHODS: Patients diagnosed with Stage I-III melanoma captured in SEER (01/2019-12/2021) were linked to Medicare claims. Cohorts were defined by stage at diagnosis with baseline characteristics evaluated during 12 months pre-diagnosis. All-cause and melanoma-related HRU and costs (2025 USD standardized) were assessed per-person-per-year (PPPY). A subgroup of Stage II/III patients treated with ICIs was also evaluated.
RESULTS: Overall, 3,978 Stage I and 1,505 Stage II/III patients were included, with mean ages of 75.7 and 78.2 years, respectively. Common primary tumor sites were arms (30.8%) for Stage I and head (30.0%) for Stage II/III patients. Superficial spreading was observed in 43.8% of Stage I patients, with nodular melanoma common in Stage II/III patients (31.2%).
During a median of 2 years follow-up, inpatient admissions occurred among 32.5% and 56.3% of Stage I and Stage II/III patients, respectively. Mean outpatient visits PPPY were 32.6 (Stage I) and 45.6 (Stage II/III). Similarly, mean melanoma-related visits PPPY were consistently higher in Stage I vs. Stage II/III for inpatient (0.1 vs. 0.4), outpatient (3.3 vs. 17.5), and home health (0.1 vs. 0.5) encounters.
Mean PPPY all-cause costs were $24,626 for Stage I and $75,515 for Stage II/III patients (melanoma-related: $3,948 and $36,031, respectively). Outpatient care was the largest subset of costs.
Stage II/III patients receiving ICIs (n=559) incurred substantially higher HRU and costs than all Stage II/III patients (mean all-cause costs: $206,045 PPPY).
CONCLUSIONS: Patients with stage II/III melanoma continue to experience substantial healthcare burden. This emphasizes the importance of early diagnosis and the need for new therapeutic options while not increasing burden.
METHODS: Patients diagnosed with Stage I-III melanoma captured in SEER (01/2019-12/2021) were linked to Medicare claims. Cohorts were defined by stage at diagnosis with baseline characteristics evaluated during 12 months pre-diagnosis. All-cause and melanoma-related HRU and costs (2025 USD standardized) were assessed per-person-per-year (PPPY). A subgroup of Stage II/III patients treated with ICIs was also evaluated.
RESULTS: Overall, 3,978 Stage I and 1,505 Stage II/III patients were included, with mean ages of 75.7 and 78.2 years, respectively. Common primary tumor sites were arms (30.8%) for Stage I and head (30.0%) for Stage II/III patients. Superficial spreading was observed in 43.8% of Stage I patients, with nodular melanoma common in Stage II/III patients (31.2%).
During a median of 2 years follow-up, inpatient admissions occurred among 32.5% and 56.3% of Stage I and Stage II/III patients, respectively. Mean outpatient visits PPPY were 32.6 (Stage I) and 45.6 (Stage II/III). Similarly, mean melanoma-related visits PPPY were consistently higher in Stage I vs. Stage II/III for inpatient (0.1 vs. 0.4), outpatient (3.3 vs. 17.5), and home health (0.1 vs. 0.5) encounters.
Mean PPPY all-cause costs were $24,626 for Stage I and $75,515 for Stage II/III patients (melanoma-related: $3,948 and $36,031, respectively). Outpatient care was the largest subset of costs.
Stage II/III patients receiving ICIs (n=559) incurred substantially higher HRU and costs than all Stage II/III patients (mean all-cause costs: $206,045 PPPY).
CONCLUSIONS: Patients with stage II/III melanoma continue to experience substantial healthcare burden. This emphasizes the importance of early diagnosis and the need for new therapeutic options while not increasing burden.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE366
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Oncology