PharmacoEconomics & Outcomes News 804, p34 - 2 Jun 2018
Teledermoscopy for skin cancer
referral: justifiable cost?
Teledermoscopy for referral to a dermatologist in
patients with suspected skin cancer in Australia appears
to increase the cost of diagnosis compared with usual
care but the cost may be justifiable in terms of faster
clinical resolution, according to findings of a study
published in JAMA Dermatology.
A decision-analytic model of primary care in Australia
was used to evaluate the cost effectiveness of
teledermoscopy referral for skin cancer diagnosis and
management by a dermatologist, compared with usual
care (written referral) for patients with suspected skin
cancer, from the Australian healthcare system
perspective. Effectiveness was measured by time to
clinical resolution (dermatologist diagnosis, or excision
of the lesion by a general practitioner).
The estimated time to clinical resolution was shorter
with teledermoscopy referral than with usual care (9 vs
35 days; difference 26 days; 95% Credible Interval [CrI]
13, 38 days). However, the estimated cost per patient
was higher with teledermoscopy referral than with usual
vs $263.75; difference $54.64; 95% CrI
$22.69, $97.35). The estimated incremental cost-
effectiveness ratio for teledermoscopy versus usual care
was $2.10 per day saved to clinical resolution.
"Implementation recommendations depend on the
preferences of the Australian health system decision
makers for either lower cost or expedited clinical
resolution," concluded the authors. "Further research
around the clinical significance of expedited clinical
resolution and its importance for patients could inform
implementation recommendations for the Australian
setting," they commented.
* Australian dollars
Snoswell CL, et al. Cost-effectiveness of Skin Cancer Referral and Consultation
Using Teledermoscopy in Australia JAMA Dermatology : 9 May 2018. Available
from: URL: http://dx.doi.org/10.1001/jamadermatol.2018.0855
PharmacoEconomics & Outcomes News 2 Jun 2018 No. 8041173-5503/18/0804-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved