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

Mbathio Dieng, Robin M. Turner, Sarah J. Lord, Andrew J. Einstein, Alexander M. Menzies, Robyn P. M. Saw, Omgo E. Nieweg, John F. Thompson and Rachael L. Morton
Additional contact information
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
Robyn P. M. Saw: Melanoma Institute Australia, North Sydney 2060, Australia
Omgo E. Nieweg: Melanoma Institute Australia, North Sydney 2060, Australia
John F. Thompson: Melanoma Institute Australia, North Sydney 2060, Australia
Rachael L. Morton: NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, Australia

IJERPH, 2022, vol. 19, issue 4, 1-13

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.

Keywords: melanoma; follow-up; cost-benefit analysis; decision support techniques; diagnostic imaging (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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