A National Budget Impact Analysis of a Specialised Surveillance Programme for Individuals at Very High Risk of Melanoma in Australia

Watts, Caroline; Wortley, Sally; Norris, Sarah; Menzies, Scott W.; Guitera, Pascale; Askie, Lisa; Mann, Graham J.; Morton, Rachael L.; Cust, Anne E.

doi:10.1007/s40258-017-0368-0

Cited by 7 publications

(4 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Uncertainty will be assessed through a scenario, one-way and probabilistic sensitivity analyses. A budget impact analysis similar to our prior study [ 9 ] will estimate the affordability of MSP to the Australian healthcare system and Medicare at scale. Technical details about the economic evaluation will be documented in the Health Economics Analysis Plan (HEAP).…”

Section: Methodsmentioning

confidence: 99%

“…The main drivers of cost-effectiveness were the detection of melanoma at an earlier stage, resulting in less extensive treatment and better quality of life, and fewer excisions for suspicious lesions with specialised surveillance in the hospital outpatient setting (annual mean rate 0.81; 95% CI, 0.72 to 0.91) compared with standard care in the community (2.55; 95% CI, 2.34 to 2.76). A subsequent budget impact analysis indicated that the Australian healthcare system would save AU $22.6 million over 5 years by using specialised melanoma surveillance incorporating TBP, compared with standard care, for people at very high risk of melanoma [ 9 ]. While the evidence has been deemed sufficient to update Australian melanoma clinical practice guidelines [ 10 ], MSP is not listed on the Medicare Benefits Schedule because the Medical Services Advisory Committee advised the Minister for Health that the available evidence in relation to comparative safety, clinical effectiveness and cost-effectiveness was not sufficient to support the public funding of MSP [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Study protocol for a randomised controlled trial to evaluate the use of melanoma surveillance photography to the Improve early detection of MelanomA in ultra-hiGh and high-risk patiEnts (the IMAGE trial)

Yan

Cust

Soyer

et al. 2023

Trials

Self Cite

View full text Add to dashboard Cite

Introduction Melanoma surveillance photography (MSP) is a comprehensive surveillance method that comprises two- or three-dimensional total body photography with tagged digital dermoscopy, performed at prescribed intervals. It has the potential to reduce unnecessary biopsies and enhance early detection of melanoma, but it is not yet standard care for all high-risk patients in Australia. This protocol describes a randomised controlled trial (RCT) designed to evaluate the clinical impact and cost-effectiveness of using MSP for the surveillance of individuals at ultra-high or high risk of melanoma from a health system perspective. Methods and design This is a registry-based, unblinded, multi-site, parallel-arm RCT that will be conducted over 3 years. We aim to recruit 580 participants from three Australian states: Victoria, New South Wales and Queensland, via state cancer registries or direct referral from clinicians. Eligible participants within 24 months of a primary cutaneous melanoma diagnosis will be randomised 1:1 to receive either MSP in addition to their routine clinical surveillance (intervention group) or routine clinical surveillance without MSP (control group). Most participants will continue surveillance with their usual care provider, and the frequency of follow-up visits in both groups will depend on the stage of their primary melanoma and risk factors. The primary outcome measure of the study is the number of unnecessary biopsies (i.e. false positives, being cases where a lesion is biopsied due to suspected melanoma on clinical examination, either with or without MSP, but the resulting histopathology finding is negative for melanoma). Secondary outcomes include the evaluation of health economic outcomes, quality of life and patient acceptability. Two sub-studies will explore the benefit of MSP in high-risk patients prior to a melanoma diagnosis and the diagnostic performance of MSP in the teledermatology setting compared to the en face clinical setting. Discussion This trial will determine the clinical efficacy, cost-effectiveness and affordability of MSP to facilitate policy decision-making at the national and local levels, across primary and specialist care. Trial registration ClinicalTrials.gov NCT04385732. Registered on May 13, 2020.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Study protocol for a randomised controlled trial to evaluate the use of melanoma surveillance photography to the Improve early detection of MelanomA in ultra-hiGh and high-risk patiEnts (the IMAGE trial)

Yan

Cust

Soyer

et al. 2023

Trials

Self Cite

View full text Add to dashboard Cite

show abstract

“…Mean annual and total healthcare use, costs and QALYs will be quantified for the cohort, preinception and postinception. A budget impact analysis (BIA) will be modelled using best practice methods [23][24][25] over a 5-year time frame. In this BIA, several scenarios will be investigated for the provision of services in a staged implementation in which 50% of eligible Australians will access 3D total body photography in year 1, subsequently rising to 60% in year 2, 70% in year 3, 80% in year 4 and 90% in year 5.…”

Section: Economic Analysismentioning

confidence: 99%

ACEMID cohort study: protocol of a prospective cohort study using 3D total body photography for melanoma imaging and diagnosis

Koh,

Cust,

Fernández-Peñas

et al. 2023

BMJ Open

View full text Add to dashboard Cite

IntroductionThree-dimensional (3D) total body photography may improve early detection of melanoma and facilitate surveillance, leading to better prognosis and lower healthcare costs. The Australian Centre of Excellence in Melanoma Imaging and Diagnosis (ACEMID) cohort study will assess long-term outcomes from delivery of a precision strategy of monitoring skin lesions using skin surface imaging technology embedded into health services across Australia.Methods and analysisA prospective cohort study will enrol 15 000 participants aged 18 years and above, across 15 Australian sites. Participants will attend study visits according to their melanoma risk category: very high risk, high risk or low/average risk, every 6, 12 and 24 months, respectively, over 3 years. Participants will undergo 3D total body photography and dermoscopy imaging at study visits. A baseline questionnaire will be administered to collect sociodemographic, phenotypic, quality of life and sun behaviour data. A follow-up questionnaire will be administered every 12 months to obtain changes in sun behaviour and quality of life. A saliva sample will be collected at the baseline visit from a subsample.Ethics and disseminationThe ACEMID cohort study was approved by the Metro South Health Human Research Ethics Committee (approval number: HREC/2019/QMS/57206) and the University of Queensland Human Research Ethics Committee (approval number: 2019003077). The findings will be reported through peer-reviewed and lay publications and presentations at conferences.Trial registration numberACTRN12619001706167.

show abstract

“…Specialised surveillance of individuals at a high risk of developing melanoma appears to be cost effective from preliminary studies showing it can lead to a decrease in yearly healthcare costs in Australia of more than 22 million AUD [ 14 ]. Total-body photography (TBP) is a recommended screening and surveillance method for individuals at a high risk of developing melanoma [ 1 ].…”

Section: This Is New!mentioning

confidence: 99%

A 3D total-body photography research network: the Australian experiment

2022

View full text Add to dashboard Cite

A National Budget Impact Analysis of a Specialised Surveillance Programme for Individuals at Very High Risk of Melanoma in Australia

Abstract: Specialised melanoma surveillance is likely to provide substantial cost savings for the Australian healthcare system.

Cited by 7 publications

References 37 publications

Study protocol for a randomised controlled trial to evaluate the use of melanoma surveillance photography to the Improve early detection of MelanomA in ultra-hiGh and high-risk patiEnts (the IMAGE trial)

Study protocol for a randomised controlled trial to evaluate the use of melanoma surveillance photography to the Improve early detection of MelanomA in ultra-hiGh and high-risk patiEnts (the IMAGE trial)

ACEMID cohort study: protocol of a prospective cohort study using 3D total body photography for melanoma imaging and diagnosis

A 3D total-body photography research network: the Australian experiment

Contact Info

Product

Resources

About