Abstract:
BACKGROUND : Skin cancer is a growing public health problem in South Africa due to its high ambient ultraviolet
radiation environment. The purpose of this study was to estimate the annual health system costs of cutaneous
melanoma, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in South Africa, incorporating both the
public and private sectors.
METHODS : A cost-of-illness study was used to measure the economic burden of skin cancer and a ‘bottom-up’
micro-costing approach. Clinicians provided data on the patterns of care and treatments while national costing
reports and clinician fees provided cost estimates. The mean costs per melanoma and per SCC/BCC were extrapolated
to estimate national costs using published incidence data and official population statistics. One-way and probabilistic
sensitivity analyses were undertaken to address the uncertainty of the parameters used in the model.
RESULTS : The estimated total annual cost of treating skin cancers in South Africa were ZAR 92.4 million (2015)
(or US$15.7 million). Sensitivity analyses showed that the total costs could vary between ZAR 89.7 to 94.6 million
(US$15.2 to $16.1 million) when melanoma-related variables were changed and between ZAR 78.4 to 113.5 million
($13.3 to $19.3 million) when non-melanoma-related variables were changed. The primary drivers of overall costs were
the cost of excisions, follow-up care, radical lymph node dissection, cryotherapy and radiation therapy.
CONCLUSION : The cost of managing skin cancer in South Africa is sizable. Since skin cancer is largely preventable
through improvements to sun-protection awareness and skin cancer prevention programs, this study highlights
these healthcare resources could be used for other pressing public health problems in South Africa.
