OBJECTIVES: To evaluate cost of care and cost differences among patients with early and late stages of melanoma who received care within a large network of US community oncology clinics.

METHODS: Adult patients diagnosed with melanoma in The US Oncology Network from October 2015 through June 2022 were included. Data were retrospectively sourced from the iKnowMed™ (iKM) oncology-specific electronic health record that captures outpatient practice encounter histories for nearly 40% of US community oncology practices. iKM records are deterministically linked to claims and remittance data. All costs were paid amount, standardized to 2022 US dollars ($), and analyzed descriptively as cost per patient per month (PPPM) longitudinally since 2015.

RESULTS: This study included an eligible subset of 5,664 patients across all 4 US census divisions. The median [Q1, Q3] age was 67 [57, 75], 39% were women, 85% were white, 6.4% were treated in rural areas. The payer type distribution was 30% commercial, 63% Medicare, 6% Medicaid, and 0.5% other. The median [Q1, Q3; same below] total outpatient medical care costs were $6.1k [1.8k, 12.7k] PPPM, $2.8k [0.5k, 6.9k] and $10.3k [4.9k, 16.4k] for all patients, patients with early and metastatic diseases, respectively. The majority of the outpatient costs were for chemotherapies ($5.1k [0.7k, 11.8k]), with significantly higher cost for metastatic disease ($9.2k [4.1k, 15.3k]) as compared to non-metastatic disease ($1.4k [0.05k, 5.9k]; p<0.001). There were significant changes in overall costs over the past 5 years, from $2.4k [0.6k, 6.6k] in 2015 to $11.3k [5.6k, 16.7k] in 2022 (P<0.001).

CONCLUSIONS: The cost of treating melanoma has increased over time and is significantly higher among patients with metastatic disease. These results may provide oncology stakeholders with insights into how advancements in melanoma care influence costs and the cost benefits of identifying melanoma before it becomes metastatic.