Hornberger J, et al. - In patients with primary cutaneous pigmented lesions suggestive of melanoma, the potential cost savings of a noninvasive gene expression test (the pigmented lesion assay [PLA]) vs visual assessment followed by biopsy and histopathologic assessment (VAH) were assessed. According to findings, PLA offered not only reduced cost but also could be beneficial for improving the patient care.

Methods

• Based on consensus treatment guidelines and fee schedules from the Centers for Medicare & Medicaid Services, researchers conducted this health economic analysis using a US payer perspective.
• From routine use of the test in US dermatology practices and literature, they derived data for model input.
• This study included patients with primary cutaneous pigmented lesions suggestive of melanoma.
• Data analysis was carried out from February 8 to December 1, 2017.
• The relative reduction in costs of diagnostic surgical procedures for PLA vs VAH management was primarily assessed; stage-related treatment costs associated with delays in diagnosis were assessed in additional analyses.

Results

• Assuming $0 for the PLA to facilitate multiple comparison scenarios, -$395 was the estimated relative reduction in surgical procedure costs (biopsy and subsequent excision), compared with VAH, in the cost analysis for this economic model.
• Compared with VAH, -$433 was the estimated relative reduction in stage-related treatment costs associated with the PLA, primarily related to avoidance of delays due to false-negative diagnoses.
• PLA led to reduction in the surveillance costs by -$119.
• For fully adjudicating a lesion suggestive of melanoma by VAH, the estimated total cost was $947.
• As per the observations, cost savings of $447 (47%) per lesion tested could be realized at a mean selling price reference point for PLA of $500.