Lifetime cost-effectiveness of skin cancer prevention through promotion of daily sunscreen use

Value Health. Mar-Apr 2012;15(2):261-8. doi: 10.1016/j.jval.2011.10.009. Epub 2011 Dec 15.

Abstract

Objectives: Health-care costs for the treatment of skin cancers are disproportionately high in many white populations, yet they can be reduced through the promotion of sun-protective behaviors. We investigated the lifetime health costs and benefits of sunscreen promotion in the primary prevention of skin cancers, including melanoma.

Methods: A decision-analytic model with Markov chains was used to integrate data from a central community-based randomized controlled trial conducted in Australia and other epidemiological and published sources. Incremental cost per quality-adjusted life-year was the primary outcome. Extensive one-way and probabilistic sensitivity analyses were performed to test the uncertainty in the base findings with plausible variation to the model parameters.

Results: Using a combined household and government perspective, the discounted incremental cost per quality-adjusted life-year gained from the sunscreen intervention was AU$40,890. Over the projected lifetime of the intervention cohort, this would prevent 33 melanomas, 168 cutaneous squamous-cell carcinomas, and 4 melanoma-deaths at a cost of approximately AU$808,000. The likelihood that the sunscreen intervention was cost-effective was 64% at a willingness-to-pay threshold of AU$50,000 per quality-adjusted life-year gained.

Conclusions: Subject to the best-available evidence depicted in our model, the active promotion of routine sunscreen use to white populations residing in sunny settings is likely to be a cost-effective investment for governments and consumers over the long term.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Australia / epidemiology
  • Cost-Benefit Analysis
  • Decision Support Techniques
  • Female
  • Health Care Costs / trends*
  • Health Promotion*
  • Humans
  • Male
  • Markov Chains
  • Melanoma / epidemiology
  • Melanoma / prevention & control
  • Middle Aged
  • Neoplasm Staging
  • Primary Prevention / economics
  • Skin Neoplasms / economics
  • Skin Neoplasms / prevention & control*
  • Sunscreening Agents / therapeutic use*

Substances

  • Sunscreening Agents