title: The cost-effectiveness of sentinel node biopsy in patients with intermediate thickness primary cutaneous melanoma.
abstract: BACKGROUND
  The aim of this study was to determine the cost-effectiveness of wide excision (WEX) + sentinel node biopsy (SNB) compared with WEX only in patients with primary melanomas >/=1 mm in thickness.
  
  
  METHODS
  A Markov model was populated with probabilities of disease progression and survival from the published literature. Costs were obtained from diagnostic-related group weightings and health outcomes were measured in quality-adjusted life years (QALYs).
  
  
  RESULTS
  Base case analyses suggested that, over a 20-year timeframe, the mean total cost per patient receiving WEX only was AU $23,182 with 10.45 life years (LY) and 9.90 QALYs. The mean cost per patient for WEX + SNB was AU $24,045 with 10.77 LY and 10.34 QALYs. The incremental cost effectiveness ratio for WEX + SNB was AU $2,770 per LY and AU $1,983 per QALY.
  
  
  CONCLUSIONS
  WEX + SNB appears to offer an improvement in health outcomes (in both LYs and QALYs) with only a slight increase in cost.
authors.affiliation: Sydney Melanoma Unit, Discipline of Surgery, The University of Sydney, Sydney, NSW, Australia. rachaelm@health.usyd.edu.au
authors.forename: R L
authors.initials: RL
authors.lastname: Morton
authors.forename: K
authors.initials: K
authors.lastname: Howard
authors.forename: J F
authors.initials: JF
authors.lastname: Thompson
mesh_terms: D003362:Cost-Benefit Analysis; D018450:Disease Progression; D006801:Humans; D008390:Markov Chains; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D021701:Sentinel Lymph Node Biopsy / Q000191:economics*; D012878:Skin Neoplasms / Q000473:pathology*