Melanoma prevention programme using genomic risk information likely a cost-effective strategy
October 17, 2023
Abstract
Purpose:
Evidence indicates a melanoma prevention program using personalized genomic risk provision and genetic counselling, can impact prevention behaviors, including reducing sunburns in adults with no melanoma history. This analysis evaluated its longer-term cost-effectiveness from an Australian health system perspective.
Methods:
The primary outcome was incremental cost effectiveness ratio (ICER) of genomic risk provision (intervention) compared with standard prevention advice. A decision-analytic Markov model was developed using randomized trial data to simulate lifetime cost-effectiveness. All costs were presented in 2018/19 Australian dollars (AUD). The intervention effect on reduced sunburns was stratified by sex and traditional risk, which was calculated through a validated prediction model. Deterministic and probabilistic sensitivity analyses were undertaken for robustness checks.
Results:
The per participant cost of intervention was AUD$189. Genomic risk provision targeting high-traditional risk individuals produced an ICER of AUD$35,254 (per QALY gained); sensitivity analyses indicated the intervention would be cost-effective in more than 50% of scenarios. When the intervention was extended to low-traditional risk groups, the ICER was AUD$43,746 with a 45% probability of being cost-effective.
Conclusion:
Genomic risk provision targeted to high-traditional melanoma risk individuals is likely a cost-effective strategy for reducing sunburns and will likely prevent future melanomas and keratinocyte carcinomas.
Source:
Chi Kin Law, Anne E. Cust, Amelia K. Smit, Lyndal Trevena, Pablo Fernandez-Penas, Omgo E. Nieweg, Alexander M. Menzies, Sarah Wordsworth, Rachael L. Morton, Long-term cost-effectiveness of a melanoma prevention program using genomic risk information compared with standard prevention advice in Australia, Genetics in Medicine, 2023, 100970, ISSN 1098-3600,
https://doi.org/10.1016/j.gim.2023.100970.