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Table A14–1 Incidence and Melanoma

Age Groups

Population

Incidence Rates (per 100,000)

% Distribution of Cases

<1

3,963,000

0.0

0.0000

1–4

16,219,000

0.0

0.0000

5–14

38,056,000

0.2

0.0022

15–24

36,263,000

2.7

0.0279

25–34

41,670,000

8.6

0.1030

35–44

42,149,000

14.9

0.1808

45–54

30,224,000

20.7

0.1798

55–64

21,241,000

27.4

0.1673

65–74

18,964,000

33.3

0.1815

75–84

11,088,000

36.1

0.1153

85+

3,598,000

40.8

0.0422

Total

263,435,000

13.2

1.0000

 

Total Cases

34,753

23 months of recovery and follow-up from non-metastatic disease to 0.18 for 3 months of treatment for metastatic disease. See Table A14–2.

COST INCURRED BY DISEASE

Table A14–3 summarizes the health care costs incurred by melanoma. For the purposes of the calculations in this report, it was assumed that local disease is associated with costs for outpatient surgery, four specialist physician visits per year for 2 years and, for 75% of patients, 2 physician visits per year for 5 years. Regional disease with no subsequent metastases was associated with outpatient surgery and six specialist physician visits. The recovery phase for this scenario was assumed to involve slightly more physician visits and folllow-up surgery for 90% of patients.

Regional disease associated with development of metastatic disease was associated with costs including extensive surgery, follow-up treatment, multiple visits to a specialist physician and after-care treatment. Patients who present with metastatic melanoma at diagnosis are assumed to require in-home care and multiple visits with a physician for 3 months.

VACCINE DEVELOPMENT

The committee assumed that it will take 7 years until licensure of a therapeutic melanoma vaccine and that $360 million needs to be invested. Appendix 31 summarizes vaccine development assumptions for all vaccines considered in this report.



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