The treatment of advanced melanoma represents a significant burden to the health system, and differs by insurance type and geographic location, according to the results of a regional analysis.
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The highest financial burdens were observed in the Northeast region of the United States and among commercial insurance payers.
Researchers from Bristol-Myers Squibb (Plainsboro, NJ) and Novosys Health (Basking Ridge, NJ) used MarketScan Commercial and Medicare databases to identify adult patients with stage III or stage IV melanoma treated with a cancer therapy between January 2011 and August 2015. Patient stratification occurred based on insurance type (commercial vs Medicare) and geographic region (Northeast, North Central, South, West).
The researchers evaluated all-cause and disease-specific health care costs per patient per month at baseline (12 months after treatment initiation) and at follow-up (up to 2 years after treatment initiation).
The study included data from 2671 patients, 85.5% of whom has stage IV melanoma. Commercial insurance covered 67.5% of patients, with Medicare covering the remaining 32.5%. The South region accounted for the largest population (34.6%), followed by North Central (25.5%), West (19.3%), and Northeast (17.8%).
Commercially insured patients had greater all-cause health care expenditures than patients insured through Medicare at follow-up (mean, $54,778±$48,358 vs $39,306±$42,853; P < .001); outpatient medical services served as the greatest cost driver ($45,271±$48,649 vs $33,413±$42,927; P < .001). The increased costs borne by commercially insured patients extended to disease-specific health care expenditures ($44,758±$46,941 vs $31,788±$41,128; P < .001).
Geographically, the highest health care expenditures between baseline and follow-up were seen in the Northeast region ($53,093±$59,191); the South ($37,849±$42,178) had the lowest expenditures (P < .001 for comparison). – Cameron Kelsall
