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BMC Health Services Research

, 16:113

Utilization, expenditure, economics and financing systems

Abstract

BackgroundSkin cancer is a growing public health problem in South Africa due to its high ambient ultraviolet radiation environment. The purpose of this study was to estimate the annual health system costs of cutaneous melanoma, squamous cell carcinoma SCC and basal cell carcinoma BCC in South Africa, incorporating both the public and private sectors.

MethodsA cost-of-illness study was used to measure the economic burden of skin cancer and a ‘bottom-up’ micro-costing approach. Clinicians provided data on the patterns of care and treatments while national costing reports and clinician fees provided cost estimates. The mean costs per melanoma and per SCC-BCC were extrapolated to estimate national costs using published incidence data and official population statistics. One-way and probabilistic sensitivity analyses were undertaken to address the uncertainty of the parameters used in the model.

ResultsThe estimated total annual cost of treating skin cancers in South Africa were ZAR 92.4 million 2015 or US$15.7 million. Sensitivity analyses showed that the total costs could vary between ZAR 89.7 to 94.6 million US$15.2 to $16.1 million when melanoma-related variables were changed and between ZAR 78.4 to 113.5 million $13.3 to $19.3 million when non-melanoma-related variables were changed. The primary drivers of overall costs were the cost of excisions, follow-up care, radical lymph node dissection, cryotherapy and radiation therapy.

ConclusionThe cost of managing skin cancer in South Africa is sizable. Since skin cancer is largely preventable through improvements to sun-protection awareness and skin cancer prevention programs, this study highlights these healthcare resources could be used for other pressing public health problems in South Africa.

KeywordsCost-of-illness Melanoma Squamous cell carcinoma Basal cell carcinoma Skin cancer AbbreviationsAIDSAcquired Immunodeficiency Disease

BCCbasal cell carcinoma

CMcutaneous melanoma

HIVhuman immunodeficiency virus

HPVHuman papilloma virus

NCRNational Cancer Registry

SCCSquamous cell carcinoma

USDUnited States Dollars

ZARSouth African Rand

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Author: Louisa G. Gordon - Thomas M. Elliott - Caradee Y. Wright - Nicola Deghaye - Willie Visser

Source: https://link.springer.com/







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