Real-World Direct Medical Costs and Clinical Outcomes of Immunotherapy and Targeted Therapy for Cutaneous Melanoma: A Bottom-Up Cost-of-Illness Study in a Public Healthcare System
4 affiliations
- 1Centre for Clinical Pharmacology, Military Medical Academy, 11000 Belgrade, Serbia
- 2Faculty of Medicine of the Military Medical Academy, University of Defence, 11000 Belgrade, Serbia
- 3Institute for Radiology, Military Medical Academy, 11000 Belgrade, Serbia
- 4Clinic for Dermatovenerology, Military Medical Academy, 11000 Belgrade, Serbia
Abstract
Background/Objectives: Immunotherapy and targeted therapy improve melanoma survival but raise costs. Real-world cost and outcome data are scarce, especially in Central and Eastern Europe. We estimated per-patient costs and outcomes in Serbia’s public healthcare system. Methods: This retrospective, single-centre study assessed costs in 183 patients with cutaneous melanoma who received systemic therapy at a Serbian tertiary centre (2019–2026). Direct medical costs were reconstructed from invoices and discharge letters from the healthcare-sector perspective. Censoring-adjusted mean 24-month costs were estimated from diagnosis (n = 165) and treatment start (n = 179). Outcomes included overall survival (OS), real-world progression-free survival (rwPFS), and time to next treatment or death (TNT-D). Results: Mean 24-month costs per patient were EUR 66,466 (95% CI 58,465–75,334) from diagnosis (EUR 75,388 with the partitioned estimator), 94.7% for systemic therapy, and EUR 107,229 (95% CI 97,405–118,201) from treatment start. At diagnosis, costs were about twice as high in stages III–IV as in stages I–II. By stage at treatment start, costs were similar in stages III and IV (EUR 102,122 vs. 104,535) despite shorter stage IV survival (p < 0.001). Two-year OS was 91.5% for adjuvant and 51.9% for metastatic first-line intent. Conclusions: Systemic therapy drove costs, which were similar in stages III and IV despite poorer stage IV survival. The cost measurement starting point substantially affected estimates and should be reported.
Related
- Machine learning based regulatory T cells related gene signature for predicting the clinical outcome and immunotherapy benefits in skin cutaneous melanoma
- Clinical and histopathological patterns of American cutaneous leishmaniasis: diagnostic and therapeutic implications for targeted therapy
- Immune reconstitution and clinical outcomes in B-ALL patients with versus without pre-HSCT Immunotherapy
- HER2-Low Breast Cancer: A Review of Epidemiology, Diagnostic Challenges, Targeted Therapies, and Clinical Outcomes
- Nutritional disorders have adverse effect on clinical outcomes and may increase healthcare costs following hip and knee arthroplasty—A systematic review
BibTeX
@article{kovacevic2026realworld,
title = {{Real-World Direct Medical Costs and Clinical Outcomes of Immunotherapy and Targeted Therapy for Cutaneous Melanoma: A Bottom-Up Cost-of-Illness Study in a Public Healthcare System}},
author = {Aleksandra M. Kovačević and Tijana G. Stanojković and Milijana N. Miljković and Viktorija M. Dragojević Simić and Bojana M. Cikota Aleksić and Nemanja K. Rančić and Lidija O. Kandolf},
journal = {Cancers},
year = {2026},
month = nov,
doi = {10.3390/cancers18213540},
url = {https://www.mdpi.com/2072-6694/18/21/3540},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Real-World Direct Medical Costs and Clinical Outcomes of Immunotherapy and Targeted Therapy for Cutaneous Melanoma: A Bottom-Up Cost-of-Illness Study in a Public Healthcare System
AU - Aleksandra M. Kovačević
AU - Tijana G. Stanojković
AU - Milijana N. Miljković
AU - Viktorija M. Dragojević Simić
AU - Bojana M. Cikota Aleksić
AU - Nemanja K. Rančić
AU - Lidija O. Kandolf
PY - 2026
DA - 2026/11/04
JO - Cancers
DO - 10.3390/cancers18213540
UR - https://www.mdpi.com/2072-6694/18/21/3540
AB - Background/Objectives: Immunotherapy and targeted therapy improve melanoma survival but raise costs. Real-world cost and outcome data are scarce, especially in Central and Eastern Europe. We estimated per-patient costs and outcomes in Serbia’s public healthcare system. Methods: This retrospective, single-centre study assessed costs in 183 patients with cutaneous melanoma who received systemic therapy at a Serbian tertiary centre (2019–2026). Direct medical costs were reconstructed from invoices and discharge letters from the healthcare-sector perspective. Censoring-adjusted mean 24-month costs were estimated from diagnosis (n = 165) and treatment start (n = 179). Outcomes included overall survival (OS), real-world progression-free survival (rwPFS), and time to next treatment or death (TNT-D). Results: Mean 24-month costs per patient were EUR 66,466 (95% CI 58,465–75,334) from diagnosis (EUR 75,388 with the partitioned estimator), 94.7% for systemic therapy, and EUR 107,229 (95% CI 97,405–118,201) from treatment start. At diagnosis, costs were about twice as high in stages III–IV as in stages I–II. By stage at treatment start, costs were similar in stages III and IV (EUR 102,122 vs. 104,535) despite shorter stage IV survival (p < 0.001). Two-year OS was 91.5% for adjuvant and 51.9% for metastatic first-line intent. Conclusions: Systemic therapy drove costs, which were similar in stages III and IV despite poorer stage IV survival. The cost measurement starting point substantially affected estimates and should be reported.
SN - 2072-6694
ER -