OBJECTIVES: The aim of this study was to estimate the total annual direct costs incurred by the National Health Service (NHS) for the management and treatment of Cutaneous squamous cell carcinoma (CSCC) and advanced CSCC patients in Italy.

METHODS: A literature review was performed to identify epidemiological data, treatment pathway and costs associated with CSCC treatment in Italy. Direct costs were obtained through the analysis of the Hospital Discharge Database (SDO) for the years 2008-2014 and associated to the national tariff that cover all direct costs sustained from the NHS. Monitoring and terminal care costs were obtained from national tariffs of outpatient care service and literature respectively. An incidence-based cost of illness (COI) model was developed to estimate direct costs associated with the treatment and management of CSCC patients in Italy.

RESULTS: Italian Association of Cancer Registries (AIRTUM) estimated 11,000 incidence patients with CSCC in Italy. From the literature emerged that about 5% of CSCC patients were in advanced stage (about 600 patients). Surgical excision is the front-line treatment for patients with resectable CSCC, and it is followed by periodical follow-up. Patients with advanced CSCC had a complete response from non-surgical treatment in 46% of cases followed by standard monitoring. The COI model estimated an annual economic burden of about € 24.6 million for the management and treatment of patients with CSCC in Italy; € 2 million of which were associated to patients with advanced CSCC. The average cost per patient with advanced CSCC was higher compared to that of patient with resectable CSCC (€ 3,319 vs € 2,237 respectively).

CONCLUSIONS: Although most CSCC are successfully cured with surgical excision, a subset of CSCC are diagnosed in the advanced stage of the disease. Our analysis showed that advanced CSCC patients are associated with a higher average cost than patients with resectable CSCC.