title: Population-based estimates of survival and cost for metastatic melanoma.
abstract: BACKGROUND
  Fewer than half of all patients with metastatic melanoma survive more than 1 year. Standard treatments have had little success, but recent therapeutic advances offer the potential for an improved prognosis. In the present study, we used population-based administrative data to establish real-world baseline estimates of survival outcomes and costs against which new treatments can be compared.
  
  
  METHODS
  Data from administrative databases and patient registries were used to find a cohort of patients with metastatic melanoma in Ontario. To identify individuals most likely to receive new treatments, we focused on patients eligible for second-line treatment. The identified cohort had two characteristics: no surgical resection beyond primary skin excision, and receipt of first-line systemic therapy.
  
  
  RESULTS
  Patient characteristics, Kaplan-Meier survival curves, and mean costs are reported. Of the 33,585 patients diagnosed with melanoma in Ontario from 1 January 1991 to 31 December 2010, 278 met the study inclusion criteria. Average age was 63 years, and 62% of the patients were men. Overall survival was estimated to be 19%, 12%, and 6% at 12, 24, and 60 months respectively. Mean survival time was 11.5 months, and mean cost was $30,685.
  
  
  CONCLUSIONS
  Our baseline estimates indicate that survival outcomes are poor and costs are high for patients receiving standard treatment. Understanding the relative improvement accruing from any new treatment requires a comparison with the existing standard of care.
authors.affiliation: Ivey Business School at Western University, London, ON;
authors.forename: C E
authors.initials: CE
authors.lastname: McCarron
authors.affiliation: London Regional Cancer Program, London, ON.
authors.forename: S
authors.initials: S
authors.lastname: Ernst
authors.affiliation: London Regional Cancer Program, London, ON.
authors.forename: J Q
authors.initials: JQ
authors.lastname: Cao
authors.affiliation: Ivey Business School at Western University, London, ON;
authors.forename: G S
authors.initials: GS
authors.lastname: Zaric
keywords: Metastatic melanoma; comparative effectiveness research; cost; effectiveness; population-based data; real-world