Economic evaluation of skin cancer prevention in Australia.
OBJECTIVE
Australia has the highest incidence of skin cancer in the world, despite prevention campaigns being implemented since the early 1980s. This study assesses the cost-effectiveness of a skin cancer prevention program (named SunSmart) since it was introduced, together with its potential cost-effectiveness as an upgraded and ongoing national program.


METHODS
The reduction in melanoma incidence attributable to SunSmart was modelled as the primary end-point. Historical expenditures on SunSmart were obtained from representative Australian states in three latitude zones. Melanoma incidence rates from these states were used to model key health outcomes. Non-melanoma skin cancer was modelled separately based on national survey results.


RESULTS
We estimate that SunSmart has averted 28,000 disability-adjusted life-years (DALYs), equivalent to 22,000 life-years saved, in the state of Victoria since its introduction in 1988, as well as saving money from cost offset in skin cancer management (dominant). An upgraded national program for the next 20 years is estimated to avert 120,000 DALYs, with associated reductions in the use of health care resources. It remains a dominant intervention in which every dollar invested in SunSmart will return an estimated AU$2.30.


CONCLUSIONS
This study demonstrates that a sustained modest investment in skin cancer control is likely to be an excellent value for money.
Shih
Sophy Ting-Fang
ST
Deakin Health Economics, Public Health Research, Evaluation and Policy Cluster, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia. sophy.shih@deakin.edu.au
Carter
Rob
R
Sinclair
Craig
C
Mihalopoulos
Cathrine
C
Vos
Theo
T
D000328:Adult; D000367:Age Factors; D000368:Aged; D017046:Cost Savings; D017281:Cost of Illness; D003362:Cost-Benefit Analysis / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education / Q000191:economics* / Q000379:methods; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000379:methods; D008545:Melanoma / Q000191:economics / Q000401:mortality / Q000517:prevention & control; D008875:Middle Aged; D011322:Primary Prevention / Q000191:economics* / Q000379:methods; D019057:Quality-Adjusted Life Years; D018570:Risk Assessment; D012737:Sex Factors; D012878:Skin Neoplasms / Q000191:economics / Q000401:mortality / Q000517:prevention & control*; D013472:Sunlight / Q000009:adverse effects*; D016019:Survival Analysis; D013997:Time Factors; D014739:Victoria