OBJECTIVES: A systematic literature review was conducted to provide an overview of the methodological approaches applied in melanoma skin cancer (MSC) and non-melanoma skin cancer (NMSC) cost-of-illness (COI) studies and to identify the main cost drivers.

METHODS: This review was conducted using the PRISMA guidelines. Pubmed, Embase and Web of Science were searched using search concepts related to skin cancer and COI. Three authors independently screened the records on eligibility criteria. A checklist for COI studies was used to assess the quality of the articles.

RESULTS: A total of 40 studies were included in this review. The majority of the studies (n=31) only focused on MSC, a few (n=3) on NMSC and six studies examined both. The study’s perspective was described in 23 articles and only 5 studies reported the epidemiological approach, indicating variation in study quality. Direct costs were estimated in all studies, while indirect costs were only estimated in 7 studies. Included cost items differed across studies. For MSC both direct and indirect costs increased as the disease stages progressed. In advanced stage MSC, systemic therapy demonstrated to be the highest cost item (44-96% of costs), while diagnosis (34%), inpatient costs (26-37%) and outpatient costs (38-44%) were the predominant cost items in NMSC. Heterogeneity was observed in cost estimates across studies, mainly due to differences in study population characteristics and methodological approaches.

CONCLUSIONS: This systematic review provides an overview of the methodological approaches in skin cancer COI studies. For advanced stage MSC, systemic therapy was the main cost drivers, indicating the need for effective treatment strategies and potential impact of targeted therapies on reducing the economic burden. For NMSC, the main cost drivers were diagnosis and in- and outpatient costs, indicating the importance of prevention and early detection. The heterogeneity in the included studies underscores the necessity for harmonized costing methodologies.