Healthcare costs of cutaneous melanoma according to comorbidity patterns: a population-based study from the Regional Cancer Registry of the Veneto Region

Alessandra Buja^1*Fortunato Cassalia¹Massimo Rugge¹Chiara Trevisiol^2*Manuel Zorzi³Paolo Del Fiore²Ilaria Pantaleo¹Carlo Riccardo Rossi¹Pierfranco Conte⁴Anna Belloni Fortina¹Simone Mocellin^1,2

• ¹Universita degli Studi di Padova, Padua, Italy
• ²Veneto Institute of Oncology (IRCCS), Padua, Italy
• ³Azienda Zero, Padua, Italy
• ⁴IRCCS Ospedale San Camillo, Venice, Italy

Background: Cutaneous malignant melanoma represents a notable public health issue, characterized by a rapidly increasing incidence, particularly among younger populations. Despite progress in early detection and treatment modalities, this rising trend exacerbates the healthcare system’s burden. Limited research has been conducted on the impact of comorbidities on overall and melanoma-specific healthcare costs incurred by patients with melanoma. The objective of this study is to assess how various comorbidity patterns influence healthcare costs in this patient population. Methods: This retrospective cohort study reviewed data from the Regional Cancer Registry of the Veneto Region (RTV) for melanoma diagnoses in 2019 and 2021. Patients were grouped into specific comorbidity clusters using latent class analysis, and the effect of these patterns on melanoma healthcare costs was evaluated from a health system perspective, considering only the direct costs incurred by the regional health care service. Results: The study included 2,978 cases of incident melanoma. The 2,114 patients with comorbidity data available were categorized into three comorbidity clusters: Circulatory-Metabolic-Respiratory, Psychosocial-Pregnancy related, and Multiorgan-Trauma. The mean unadjusted overall and melanoma-specific cumulative expenditure per patient increased with the number of comorbidities: melanoma-specific healthcare resources were € 13,537 (no comorbidity), € 16,828 (one comorbidity), € 20,396 (Multiorgan-Trauma cluster). Hospitalizations were the primary driver of cost escalation, particularly for patients with Multiorgan-Trauma comorbidities. Conclusions: Comorbidity patterns significantly impact melanoma management and related healthcare costs. Understanding these patterns can help optimize resource allocation and improve patient management strategies.