Costs of routine skin cancer screening in Germany: a claims data analysis.

Abstract

In 2008, a routine skin cancer screening (rSCS) programme was implemented in Germany. Since then, its medical and economical effects have been evaluated and critically discussed. To compare costs for patients diagnosed with skin cancer with preceding rSCS vs. those diagnosed without rSCS. We conducted a retrospective observational study using claims data from a large German health insurance company for the period 2013-2016. We applied entropy balancing, difference-in-differences estimation and generalized linear models to compare costs for patients with cancer with and without rSCS. We conducted sensitivity analyses to test for the robustness of results. In total, 12790 patients with skin cancer were included in the analyses, of whom 6041 were diagnosed by rSCS. Treatment costs were €467 higher for patients in the control group (without rSCS). However, the screening costs were higher. For all people covered by the health insurance company, there were additional costs of €1339-1431 per patient with skin cancer diagnosed by rSCS. Thus, total costs, including costs for treatment and screening, were €872-964 higher for patients diagnosed by rSCS. Based on our analysis, rSCS has the potential to reduce treatment costs; however, the screening costs exceed these savings.