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Vaccines for the 21st Century A Tool for Decisionmaking (2000) / Chapter Skim
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Appendix 14: Melanoma
Pages 239-244

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From page 239...
... Malignant melanoma can be clinically divided into four main types: superficial spreading melanoma, nodular melanoma, lentigo maligna melanoma, and acral lentiginous melanoma. DISEASE BURDEN Epidemiology For the purposes of the calculations in this report, the committee estimated that there are approximately 35,000 new cases of melanoma every year in the United States.
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From page 240...
... 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.
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From page 241...
... or 5.9855 (unadjusted life expectancy) Table A14-3 Health Care Costs Associated with Melanoma % with Cost per Units per Care Unit Case Form of Treatment Local disease surgery 100% $2,000 1.0 outpatient surgery recovery 100% $100 4.0 physician lo/year follow-up 75% $50 2.0 physician a/year Regional at diagnosis, no metastases treatment phase 100% $2,000 1.0 outpatient surgery 100% $100 6.0 physician b recovery 90% $100 4.0 physician lo/year 90% $2,000 1.0 follow-up treatment follow-up 75% $100 2.0 physician lo/year Regional at diagnosis, develop metastatic disease treatment 100% $4,000 1.0 surgery 100% $2,000 1.0 follow-up treatment 100% $100 12.0 physician b 100% $3,000 1.0 aftercare Metastatic at diagnosis 100% 100 6.0 physician b treatment 100% $3,000 1.0 aftercare
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From page 242...
... Using committee assumptions of less-than-ideal efficacy and utilization and including time and monetary costs until a vaccine program is implemented, the annualized present value of the health care costs saved would be $36.1 million. If a vaccine program for melanoma were implemented today and the vaccine was 100% efficacious and utilized by 100% of the target population, the annualized present value of the program cost would be $53.2 million.
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From page 243...
... See Chapters 4 and 5 for details on the methods and assumptions used by the committee for the results reported. READING LIST Miller BA, Kolonel LN, Bernstein L, et al.
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Key Terms

  • target population
  • committee assumptions
  • using committee
  • including time
  • care costs

  • regional disease
  • monetary costs
  • physician visits
  • subsequent metastases
  • metastatic disease

  • specialist physician
  • costs saved
  • vaccine development
  • qalys gained
  • committee assumed

  • outpatient surgery
  • qaly gained
  • malignant melanoma
  • program cost
  • summarizes vaccine

  • melanoma vaccine
  • vaccines considered
  • local disease
  • disease scenarios
  • melanoma range

  • develop metastatic
  • lentiginous melanoma
  • lentigo maligna
  • six specialist
  • maligna melanoma


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