游戏中的皮肤:北爱尔兰皮肤癌诊断、治疗和护理的成本后果。

IF 2 Q3 HEALTH POLICY & SERVICES
Ethna McFerran , Sarah Donaldson , Olivia Dolan , Mark Lawler
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引用次数: 0

摘要

背景:皮肤癌是英国的一种常见癌症。其发病率和死亡率的上升预计将带来巨大的财务影响,尤其是对北爱尔兰(NI)皮肤癌管理的诊断和治疗服务。这种疾病的预期增长强调了采取预防和控制措施的必要性,这些措施应有助于指导决策和规划工作:我们进行了一项疾病成本研究,从医疗保健系统的角度评估皮肤癌对北爱尔兰的经济影响,采用自下而上的方法,使用 2021/22 年皮肤癌诊断和治疗患者路径的 NHS 参考成本(英镑)。敏感性分析通过对良性病例应用乘数来改变诊断量,假设诊断转换率为 6.8%,并研究了 75% 的替代化疗方案达标率。此外,根据未来恶性黑色素瘤(MM)病例诊断、治疗和随访量分别增加 9% 和 28% 的估计,预测了成本增加的比例:记录了大量非黑色素瘤皮肤癌(NMSC)和恶性黑色素瘤病例,其中 NMSC 4289 例,MM 439 例。治疗非黑色素瘤皮肤癌的总费用为 3,365,350 英镑。MM 皮肤癌的总费用为 13,740,681 英镑,其中包括 8,753,494 英镑的采购、管理和化疗药物使用费用。皮肤癌治疗的总医疗支出为 21,167,651 英镑。敏感性分析表明,根据转诊量假设,诊断成本可能会大幅增加至 12374478 英镑。如果基准费率上升 9% 或 28%,估计治疗皮肤癌的总成本将分别增至 2230 万英镑和 2490 万英镑:根据诊断转诊假设,北爱尔兰的皮肤癌治疗总成本约为 2,110 万英镑至 3,210 万英镑。在过去十年中,MM 的治疗费用增长了约 10 倍,这主要归因于化疗费用。预计到 2040 年,MM 病例将增加 28%,这将导致约 380 万英镑的额外支出,给癌症医疗系统带来巨大挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Skin in the game: The cost consequences of skin cancer diagnosis, treatment and care in Northern Ireland

Background

Skin cancer is a prevalent cancer in the UK. Its rising incidence and mortality rates are expected to result in substantial financial implications, particularly on diagnostic and treatment services for skin cancer management in Northern Ireland (NI). Such anticipated disease increases underscore the need for prevention and control measures that should help guide policymaking and planning efforts.

Methods

We conducted a cost of illness study to assess the economic impact of skin cancer in NI from the healthcare system's perspective, using a bottom-up method, employing NHS reference costs (UK£) for skin cancer diagnosis and treatment patient pathways in 2021/22. Sensitivity analyses varied diagnostic volumes by applying multipliers for benign cases, assuming a diagnostic conversion rate of 6.8%, and examined an alternative chemotherapy regimen compliance rate of 75%. Additionally, proportional cost increases were projected based on future estimated increases of 9% and 28% to malignant melanoma (MM) cases for diagnostic, treatment, and follow-up volumes.

Results

Significant numbers of non-melanoma skin cancers (NMSC) and MM cases were recorded, 4289 NMSCs and 439 MM cases. The total cost for managing NMSC was £ 3,365,350. Total costs for MM skin cancer were £ 13,740,681, including £ 8,753,494 for procurement, administration, and chemotherapy drug use. Overall healthcare spending on skin cancer care totalled £ 21,167,651. Sensitivity analysis suggested diagnostic cost may increase significantly to £ 12,374,478 based on referral volume assumptions. If base case rates rise by 9 or 28% estimated total costs of treating skin cancer will increase to £ 22.3 million and £ 24.9 million, respectively.

Conclusions

Skin cancer management costs in NI totalled ∼£ 21.1 million to £ 32.1 million, depending on diagnostic referral assumptions. Costs have risen ∼10-fold over the past decade for MM due largely to chemotherapy costs. A predicted 28% increase in MM cases by 2040 would lead to ∼£ 3.8 million of additional expenditures, providing a significant challenge for cancer health systems.

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来源期刊
Journal of Cancer Policy
Journal of Cancer Policy Medicine-Health Policy
CiteScore
2.40
自引率
7.70%
发文量
47
审稿时长
65 days
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