Economic Analysis of a Noninvasive Molecular Pathologic Assay for Pigmented Skin Lesions

JAMA Dermatology
John Hornberger, Daniel M Siegel

Abstract

A recently described noninvasive gene expression test (the pigmented lesion assay [PLA]) with adhesive patch-based sampling has the potential to rule out melanoma and the need for surgical biopsy of pigmented lesions suggestive of melanoma with a negative predictive value of 99% compared with 83% for the histopathologic standard of care. The cost implications of using this molecular test vs visual assessment followed by biopsy and histopathologic assessment (VAH) have not been evaluated. To determine potential cost savings of PLA use vs the VAH pathway. This health economic analysis performed from a US payer perspective was based on consensus treatment guidelines and fee schedules from the Centers for Medicare & Medicaid Services. Data for model input were derived from routine use of the test in US dermatology practices and literature. Participants included patients with primary cutaneous pigmented lesions suggestive of melanoma. Data were analyzed from February 8 to December 1, 2017. The primary analysis consisted of the relative reduction in costs of diagnostic surgical procedures for PLA vs VAH management. Additional analyses included stage-related treatment costs associated with delays in diagnosis. In the cost analysis for...Continue Reading

References

Dec 25, 2004·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Sara GandiniCarmelo Francesco Melchi
Apr 29, 2006·The Journal of Investigative Dermatology·Torsten SchäferUNKNOWN KORA Study Group
Jan 17, 2007·Archives of Dermatology·Elena LosinaKenneth A Freedberg
Dec 20, 2008·Clinics in Dermatology·Robert J FriedmanEdward R Heilman
Aug 12, 2009·Journal of the American Academy of Dermatology·Craig HansenGiuseppe Argenziano
Sep 10, 2009·Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]·Anne M SeidlerSuephy C Chen
Jul 31, 2010·CA: a Cancer Journal for Clinicians·Darrell S RigelRobert Friedman
Oct 20, 2010·Archives of Dermatology·Gary MonheitDina Gutkowicz-Krusin
Nov 17, 2010·Archives of Dermatology·Sallyann M Coleman KingSuephy C Chen
Jul 16, 2011·The Journal of Dermatological Treatment·Rebekah L WilsonAlan B Fleischer
Oct 11, 2011·Journal of the American Academy of Dermatology·Giuseppe ArgenzianoHarald Kittler
Oct 18, 2011·American Journal of Surgery·Geneviève L EgnatiosBarbara A Pockaj
Feb 14, 2012·Journal of the American Academy of Dermatology·Cliff RosendahlDavid Wilkinson
Feb 22, 2012·Archives of Dermatology·Keith L DuffyChristopher R Shea
Jul 24, 2012·Cell·Eran HodisLynda Chin
Sep 25, 2012·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·J Jaime CaroUNKNOWN ISPOR-SMDM Modeling Good Research Practices Task Force
Nov 7, 2012·Journal of the American Academy of Dermatology·Thomas L HockerMargot S Peters
Jan 3, 2013·Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]·Kurt GrelckGabriel P Suciu
Apr 18, 2013·American Journal of Surgery·Jane K MillsJohn T Vetto
Jun 14, 2013·JAMA Dermatology·Kavitha K ReddyGary S Rogers
Sep 30, 2014·Journal of the American Academy of Dermatology·Lauren StrazzulaDaniela Kroshinsky
Feb 24, 2015·Journal of the American Academy of Dermatology·UNKNOWN American Academy of Dermatology Ad Hoc Task Force for the ABCDEs of MelanomaWendy Smith Begolka
Nov 17, 2015·Journal of the American Academy of Dermatology·Richard R Winkelmann, Darrell S Rigel
Aug 20, 2016·JAMA Dermatology·Nathaniel H FlemingSusan M Swetter
Oct 7, 2016·Journal of the American Academy of Dermatology·Pedram GeramiLaura K Ferris
Sep 28, 2017·Journal of the American Academy of Dermatology·David M WangChrysalyne D Schmults
Oct 22, 2017·Journal of the American Academy of Dermatology·Ruzica Z ConicBrian R Gastman
Feb 22, 2018·JAMA Dermatology·Kaitlin L NuferH Peter Soyer

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Citations

Jan 31, 2019·JAMA Dermatology·Daniel M Siegel, John Hornberger
Jan 31, 2019·JAMA Dermatology·Meghan Beatson, Martin A Weinstock
May 4, 2020·Journal of the American Academy of Dermatology·Lauren FriedJennifer A Stein
Mar 22, 2021·The Journal of Investigative Dermatology·Michael A MarchettiStephen W Dusza
Jul 18, 2021·The Journal of Investigative Dermatology·Michael A Marchetti, Stephen W Dusza

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