Cost-effectiveness of a FISH assay for the diagnosis of melanoma in the USA Journal Article


Authors: Kansal, A. R.; Shaul, A. J.; Stern, S.; Busam, K.; Doucet, C. A.; Chalfin, D. B.
Article Title: Cost-effectiveness of a FISH assay for the diagnosis of melanoma in the USA
Abstract: Objective: The authors evaluated the cost-effectiveness of a FISH assay in melanoma diagnosis in the USA. Method: A model was developed simulating the addition of FISH to the diagnosis of suspected melanoma. A decision analytic module simulated diagnosis using microscopic assessment alone versus addition of FISH (sensitivity: 92%; specificity: 94%). The authors simulated a clinical setting in which an initial excisional biopsy microscopic assessment (sensitivity: 73%; specificity: 78%) was followed by dermatopathologist assessment (sensitivity: 89%; specificity: 79%) for inconclusive results. Diagnostic strategies 1 and 2 added FISH to the initial and dermatopathologist assessments, respectively. A Markov outcomes module simulated patients' remaining lifetime, including treatment. Results: In diagnostic strategies 1 and 2, the cost per quality-adjusted life year gained was US$14,930 and 43,925, respectively, versus no FISH. Cost per misdiagnosis avoided was US$3292 and 3759, respectively. Sensitivity and specificity without FISH were both ≥88%; however, addition of FISH exceeded US$100,000/quality- adjusted life year. Conclusion: In specific clinical settings, FISH could be cost effective for melanoma diagnosis. © 2013 Expert Reviews Ltd.
Keywords: melanoma; diagnosis; fish; model; economic analysis
Journal Title: Expert Review of Pharmacoeconomics and Outcomes Research
Volume: 13
Issue: 3
ISSN: 1473-7167
Publisher: Informa Healthcare  
Date Published: 2013-06-01
Start Page: 371
End Page: 380
Language: English
DOI: 10.1586/erp.13.22
PROVIDER: scopus
PUBMED: 23672374
DOI/URL:
Notes: --- - "Export Date: 1 November 2013" - "CODEN: ERPOB" - "Source: Scopus"
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  1. Klaus J Busam
    688 Busam