Assessment of the cost-effectiveness of stratifying patientswith malignant skin tumors into risk groups
HEALTHCARE ORGANIZATION
Abstract
Introduction.Cutaneous melanoma is a malignant tumor and a leading cause of death among skin cancers. In Russia, the incidence rate in 2022 was 4.8 per 100,000 population. Due to the increasing incidence rates, finding organizational solutions for early diagnosis is a relevant task. One such promising approach is the stratification of patients into risk groups.The aim of the studyis to calculate the number of patients needed to be screened to detect one case of malignant skin neoplasia in different risk groups, as well as to compare the financial costs of detecting one case of malignant skin neoplasia when using a risk-based approach versus without it.Materials and methods.Participants of the nationwide “Melanoma Diagnostic Day” screening (2021) were distributed into risk groups using a risk calculator. The number needed to be screened (NNS) to detect one case of malignant skin neoplasia was calculated. Financial analysis was conducted based on 2021 Saint Petersburg compulsory health insurance tariffs.Results.Without risk stratification, 42 people needed to be screened to detect one case of malignant skin neoplasia. When stratified into risk groups, screening efficiency increased in the medium-high risk group, where the NNS was 24 people. Financial analysis demonstrated that the cost of detecting one case of malignant skin neoplasia with a risk-based approach was only 0.57 of the cost of mass screening, equivalent to a 43% cost saving.Conclusions.This study proves that the strategy of stratifying patients into risk groups for developing malignant skin neoplasia is clinically and cost-effective. Its implementation allows for the optimized use of diagnostic resources by focusing on the medium-high risk group, where the effectiveness of screening is highest, and provides significant savings for the healthcare system budget.
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