HEALTHCARE RESOURCE USE AND COST OF CHOROIDAL MELANOMA: A REAL-WORLD RETROSPECTIVE COHORT STUDY FROM NATIONAL HEALTH SERVICE (NHS) ENGLAND PERSPECTIVE
Author(s)
Ariel Yuhan Ong, MD1, Alisha Angdembe, MPH2, Mandeep S. Sagoo, PhD1, Noemi Muszbek, MSc3, Pearse Keane, MD4, Joseph Birkett, PhD5, Ross Goldstein, MD, MBA5.
1Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom, 2Senior Health Economist, Visible Analytics Ltd, Oxford, United Kingdom, 3Visible Analytics Ltd, Reading, United Kingdom, 4University College London (UCL), London, United Kingdom, 5Aura Biosciences, Boston, MA, USA.
1Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom, 2Senior Health Economist, Visible Analytics Ltd, Oxford, United Kingdom, 3Visible Analytics Ltd, Reading, United Kingdom, 4University College London (UCL), London, United Kingdom, 5Aura Biosciences, Boston, MA, USA.
OBJECTIVES: Choroidal melanoma (CM) is the most common intraocular malignancy in adults. The management of early primary CM is varied, ranging from radiotherapy and laser ablation through to enucleation depending on tumour size and location. The aim of this study was to understand the real-world costs of early CM from a UK NHS perspective.
METHODS: A retrospective observational cohort study was conducted using real-world data from Moorfields Eye Hospital NHS Foundation Trust (2016-2024). Data comprised of electronic health records, administrative databases, specialist ocular oncology databases, and imaging metadata of patients diagnosed with confirmed early CM (tumour thickness ≥0.5 mm and ≤2.5 mm and largest basal diameter <12.0 mm). Costs covered inpatient stays, outpatient consultations, accident and emergency, imaging, and treatments. Unit costs were from the National Schedule of NHS Costs 2024/25; epidemiology data were from Cancer Research UK 2025. Total costs per patient and NHS England were estimated.
RESULTS: The cohort comprised of 640 with early CM patients (which represented 32% of uveal melanoma patients). Mean follow-up was 2.7 years. Multiple treatment pathways were identified, with 5.5% of patients receiving ≥1 treatment. Mean per-patient direct medical cost over the follow-up period was £13,115. Imaging (58.6%, mainly tomography, retinal photography, fluorescein angiography) and procedures (28.4%) were the largest cost components. With an age-standardised rate of 1.5/100,000 for eye cancer, of which 95% is uveal melanoma, the total NHS England direct medical cost of early CM over the follow-up period was £23.1 million. As some procedures are delivered at other centres, these costs are likely to be underestimated.
CONCLUSIONS: CM is a rare disease, where the complex, patient-dependent treatment pathway in early disease determines procedures and imaging, driving costs (£13,115/patient over 2.7 years). While estimates are likely conservative, they provide important evidence for economic evaluations. Further research in treatment costs would provide more precise estimates.
METHODS: A retrospective observational cohort study was conducted using real-world data from Moorfields Eye Hospital NHS Foundation Trust (2016-2024). Data comprised of electronic health records, administrative databases, specialist ocular oncology databases, and imaging metadata of patients diagnosed with confirmed early CM (tumour thickness ≥0.5 mm and ≤2.5 mm and largest basal diameter <12.0 mm). Costs covered inpatient stays, outpatient consultations, accident and emergency, imaging, and treatments. Unit costs were from the National Schedule of NHS Costs 2024/25; epidemiology data were from Cancer Research UK 2025. Total costs per patient and NHS England were estimated.
RESULTS: The cohort comprised of 640 with early CM patients (which represented 32% of uveal melanoma patients). Mean follow-up was 2.7 years. Multiple treatment pathways were identified, with 5.5% of patients receiving ≥1 treatment. Mean per-patient direct medical cost over the follow-up period was £13,115. Imaging (58.6%, mainly tomography, retinal photography, fluorescein angiography) and procedures (28.4%) were the largest cost components. With an age-standardised rate of 1.5/100,000 for eye cancer, of which 95% is uveal melanoma, the total NHS England direct medical cost of early CM over the follow-up period was £23.1 million. As some procedures are delivered at other centres, these costs are likely to be underestimated.
CONCLUSIONS: CM is a rare disease, where the complex, patient-dependent treatment pathway in early disease determines procedures and imaging, driving costs (£13,115/patient over 2.7 years). While estimates are likely conservative, they provide important evidence for economic evaluations. Further research in treatment costs would provide more precise estimates.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD25
Topic
Economic Evaluation, Real World Data & Information Systems
Disease
Oncology, Rare & Orphan Diseases, Sensory System Disorders (Ear, Eye, Dental, Skin)