A Method for Estimating Resource Use and Costs when Empirical Data Are Unavailable: Expert Elicitation Study Using...

Area of Science:

• Oncology
• Health Economics
• Medical Data Analysis

Background:

• Cancer diagnosis, management, and systemic anticancer therapy (SACT) are increasingly costly.
• Publicly available data linking these aspects are scarce, time-consuming to obtain, and difficult to analyze.
• This hinders economic modeling for new cancer interventions.

Purpose of the Study:

• To demonstrate a rapid expert elicitation method for calculating cancer diagnosis and treatment costs by disease stage.
• To apply this method to melanoma as an exemplar.
• To estimate the costs associated with melanoma diagnosis, management, and SACT.

Main Methods:

• A structured expert elicitation exercise was designed for UK-based melanoma specialists (dermatologists, oncologists, surgeons).
• Experts estimated proportions of patients offered diagnostic, management, or SACT options for different melanoma stages.
• Scaled beta distributions modeled expert beliefs, and random-effects meta-analysis pooled estimates to calculate mean costs using published unit costs.

Main Results:

• Diagnosis costs ranged from £424 to £699.
• Mean management costs varied by stage: £782 (stage 0) to £4,729 (stage 1b/2).
• Mean SACT costs were substantial for advanced stages: £65,289 (stage 3) and £134,065 (stage 4).

Conclusions:

• The novel expert elicitation approach efficiently generates cost estimates and quantifies uncertainty.
• This method provides valuable data for melanoma cost analysis in the absence of comprehensive registry information.
• Significant heterogeneity in expert estimates highlights variations in clinical practice for melanoma management.