Background & Objective:
The incidence of cutaneous malignant melanoma (CMM) has continued to rise with predominantly fair-skinned populations in recent decades. The introduction of innovative therapies has resulted in a rising burden on healthcare resources for this condition. This study analyzes potential drivers of the direct costs of healthcare services for the melanoma patient care pathway.

Methods:
A cohort study was conducted, based on all CMMs collected in 2015 and 2017 by the Veneto Cancer high-resolution registry of incident cases of melanoma (RTV). Costs were assessed from the perspective of the Italian national health system. Each patient was linked via an anonymous unique identification code to all administrative data regarding their hospital admissions, day hospital service usage, drug prescriptions, admission to the emergency room, medical devices used at home, ambulatory services, and hospice admissions. The data used to calculate the melanoma-related costs spanned from one year before the diagnosis to four years afterwards. Data were stratified by age, sex, tumor characteristics (TNM stages and histologic subtypes), and survival time.

Results:
The cost analysis showed that expenditure peaked in the first year after diagnosis and then decreased over time. Males incurred higher costs, especially during the peak (+37%). Stratifying by TNM stage, the average melanoma-related expenditure for stage I was 15 times lower than for stage IV. The largest cost item was for drugs, except for stage I disease. The nodular subtype was associated with higher costs.

Conclusion:
Hospitalization, inpatient drugs, and outpatient visits emerged as the main cost items for CMM patients. The cost of hospital stays was higher in the first year after diagnosis. In subsequent years, spending of hospitalization decreased and spending on drugs increased proportionally. Significant differences in the average costs over the 4 years after diagnosis depended on tumor’s anatomopathological features, stage of disease, and patients’ sociodemographic characteristics.