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Cost-Effectiveness of PET/CT Surveillance Schedules to Detect Distant Recurrence of Resected Stage III Melanoma

Author

Listed:
  • Mbathio Dieng

    (NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, Australia)

  • Robin M. Turner

    (Biostatistics Centre, Otago University, Dunedin 9016, New Zealand)

  • Sarah J. Lord

    (NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, Australia)

  • Andrew J. Einstein

    (Seymour, Paul, and Gloria Milstein Division of Cardiology, Department of Medicine and Radiology, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY 10032, USA)

  • Alexander M. Menzies

    (Melanoma Institute Australia, North Sydney 2060, Australia
    Department of Medical Oncology, Royal North Shore and Mater Hospitals, North Sydney 2060, Australia)

  • Robyn P. M. Saw

    (Melanoma Institute Australia, North Sydney 2060, Australia
    Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Camperdown 2050, Australia
    Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Camperdown 2050, Australia)

  • Omgo E. Nieweg

    (Melanoma Institute Australia, North Sydney 2060, Australia
    Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Camperdown 2050, Australia
    Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Camperdown 2050, Australia)

  • John F. Thompson

    (Melanoma Institute Australia, North Sydney 2060, Australia
    Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Camperdown 2050, Australia
    Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Camperdown 2050, Australia)

  • Rachael L. Morton

    (NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, Australia
    Melanoma Institute Australia, North Sydney 2060, Australia)

Abstract

Objective: To estimate the cost-effectiveness of three surveillance imaging strategies using whole-body positron emission tomography (PET) with computed tomography (CT) (PET/CT) in a follow-up program for adults with resected stage III melanoma. Methods: An analytic decision model was constructed to estimate the costs and benefits of PET/CT surveillance imaging performed 3-monthly, 6-monthly, or 12-monthly compared with no surveillance imaging. Results: At 5 years, 3-monthly PET/CT surveillance imaging incurred a total cost of AUD 88,387 per patient, versus AUD 77,998 for 6-monthly, AUD 52,560 for 12-monthly imaging, and AUD 51,149 for no surveillance imaging. When compared with no surveillance imaging, 12-monthly PET/CT imaging was associated with a 4% increase in correctly diagnosed and treated distant disease; a 0.5% increase with 6-monthly imaging and 1% increase with 3-monthly imaging. The incremental cost-effectiveness ratio (ICER) of 12-monthly PET/CT surveillance imaging was AUD 34,362 for each additional distant recurrence correctly diagnosed and treated, compared with no surveillance imaging. For the outcome of cost per diagnostic error avoided, the no surveillance imaging strategy was the least costly and most effective. Conclusion: With the ICER for this strategy less than AUD 50,000 per unit of health benefit, the 12-monthly surveillance imaging strategy is considered good value for money.

Suggested Citation

  • Mbathio Dieng & Robin M. Turner & Sarah J. Lord & Andrew J. Einstein & Alexander M. Menzies & Robyn P. M. Saw & Omgo E. Nieweg & John F. Thompson & Rachael L. Morton, 2022. "Cost-Effectiveness of PET/CT Surveillance Schedules to Detect Distant Recurrence of Resected Stage III Melanoma," IJERPH, MDPI, vol. 19(4), pages 1-13, February.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:4:p:2331-:d:752129
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    References listed on IDEAS

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    3. Thomas M. Elliott & David C. Whiteman & Catherine M. Olsen & Louisa G. Gordon, 2017. "Estimated Healthcare Costs of Melanoma in Australia Over 3 Years Post-Diagnosis," Applied Health Economics and Health Policy, Springer, vol. 15(6), pages 805-816, December.
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