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Erschienen in: Digestive Diseases and Sciences 10/2018

13.06.2018 | Original Article

Cost-Effectiveness of Melanoma Screening in Inflammatory Bowel Disease

verfasst von: Alyce J. M. Anderson, Laura K. Ferris, David G. Binion, Kenneth J. Smith

Erschienen in: Digestive Diseases and Sciences | Ausgabe 10/2018

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Abstract

Background and Aims

Inflammatory bowel disease (IBD) patients are at increased risk of melanoma and non-melanoma skin cancers, and preventive care guidelines in IBD favor annual skin examinations. Here we estimate the cost-effectiveness of annual melanoma screening in IBD.

Methods

Melanoma screening was defined as receiving annual total body skin examinations starting at age 40 from a dermatologist. Screening was compared to US background total body skin examination rates performed by primary care practitioners. A Markov model was used to estimate intervention costs and effectiveness. Future costs and effectiveness were discounted at 3% per year over a lifetime horizon. Strategies were compared using a willingness-to-pay threshold of $100,000/quality-adjusted life year (QALY) gained.

Results

Annual melanoma screening cost an average of $1961 per patient, while no screening cost $81 per patient. Melanoma screening was more effective, gaining 9.2 QALYs per 1000 persons, at a cost of $203,400/QALY gained. Screening every other year was the preferred strategy, gaining 6.2 QALYs per 1000 persons and costing $143,959/QALY. One-way sensitivity analyses suggested the relative risk of melanoma in IBD, melanoma progression, and screening costs were most influential with clinically plausible variation, leading to scenarios costing < $100,000/QALY gained. Probabilistic sensitivity analyses suggested screening every other year was cost-effective in 17.4% of iterations.

Conclusions

Screening for melanoma in IBD patients was effective but expensive. Screening every other year was the most cost-effective strategy. Studies to identify IBD patients at the highest risk of developing melanoma may assist in targeting a prevention program in the most cost-effective manner.
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Metadaten
Titel
Cost-Effectiveness of Melanoma Screening in Inflammatory Bowel Disease
verfasst von
Alyce J. M. Anderson
Laura K. Ferris
David G. Binion
Kenneth J. Smith
Publikationsdatum
13.06.2018
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 10/2018
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-018-5141-1

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