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Skin cancer projections and cost savings 2014-2045 of improvements to the Danish sunbed legislation of 2014.

ABSTRACT: BACKGROUND:Sunbed use increases the risk of skin cancer. The Danish sunbed legislation (2014) did not include an age limit. AIM:To model skin cancer incidences and saved costs from potential effects of structural interventions on prevalence of sunbed use. MATERIALS AND METHODS:Survey data from 2015 were collected for 3999 Danes, representative for the Danish population in regards to age, gender and region. Skin cancer incidences were modelled in the Prevent program, using population projections, historic cancer incidence, sunbed use exposure and relative risk of sunbed use on melanoma. RESULTS:If structural interventions like an age limit of 18 years for sunbed use or complete ban had been included in the Danish sunbed legislation in 2014, it would have reduced the annual number of skin cancer cases with 455 or 4177, respectively, while for the entire period, 2014-2045 the total reductions would be 3730 or 81 887 fewer cases, respectively. The cost savings from an age limit or ban, respectively, are 9 and 129 millions € during 2014-2045. CONCLUSION:Legislative restrictive measures which could reduce the sunbed use exists. Danish politicians have the opportunity, supported by the population, to reduce the skin cancer incidence and thereby to reduce the future costs of skin cancer.

SUBMITTER: Koster B

PROVIDER: S-EPMC7379953 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Skin cancer projections and cost savings 2014-2045 of improvements to the Danish sunbed legislation of 2014.

Køster Brian B Meyer Maria K H MKH Andersson Therese M-L TM Engholm Gerda G Dalum Peter P

Photodermatology, photoimmunology & photomedicine 20181009 2

<h4>Background</h4>Sunbed use increases the risk of skin cancer. The Danish sunbed legislation (2014) did not include an age limit.<h4>Aim</h4>To model skin cancer incidences and saved costs from potential effects of structural interventions on prevalence of sunbed use.<h4>Materials and methods</h4>Survey data from 2015 were collected for 3999 Danes, representative for the Danish population in regards to age, gender and region. Skin cancer incidences were modelled in the Prevent program, using p ...[more]

PMID: 30198585

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Project description:BackgroundOmadacycline is an oral and intravenous (IV) once-daily aminomethylcycline antibiotic that was recently approved by the US Food and Drug Administration for the treatment of patients with acute bacterial skin and skin structure infections (ABSSSI). In 2 phase 3 clinical trials, IV-to-oral switch and oral-only administration of omadacycline achieved the primary end points of noninferiority compared with linezolid in treating patients with ABSSSI.ObjectiveTo estimate the potential cost-savings with bioequivalent IV-to-oral antibiotics, such as omadacycline, compared with the standard of care with IV vancomycin by avoiding hospitalizations and reducing hospital stays in patients presenting from the emergency department for ABSSSI treatment.MethodsWe used hospital avoidance models to examine the potential cost-savings of managing patients with ABSSSI and no or limited comorbidities and without life-threatening conditions by using omadacycline in the outpatient setting compared with the current standard of care. Early hospital discharge models were used to evaluate the hospital stay reduction that would be required to be achieved with omadacycline treatment relative to IV vancomycin to confer cost-savings compared with standard of care among patients with ABSSSI and ?2 comorbidities but no life-threatening conditions.ResultsIn the hospital stay avoidance models, cost-savings may be realized by using therapeutically bioequivalent IV-to-oral antibiotics, such as omadacycline, compared with inpatient treatment with IV vancomycin. Based on a sensitivity analysis, further savings could be possible with outpatient administration of omadacycline, even if 20% of omadacycline outpatients were subsequently admitted and incurred the full inpatient cost, with no reimbursement penalties. Of more than 300 patients, only 1 was admitted to the hospital after a full course of omadacycline in the oral-only clinical trial. In the early hospital discharge models, the maximum cost-minimizing daily expense of omadacycline varied from $173 to $936, depending on the presence of active comorbidities or systemic symptoms, hospital stay reduction, and model perspective.ConclusionThese results suggest that the targeted use of antibiotics with bioequivalent IV-to-oral formulations, such as omadacycline, for select patients with ABSSSI may lead to cost-savings compared with inpatient IV vancomycin treatment by shifting care to the outpatient setting or by facilitating earlier hospital discharge among hospitalized patients.

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Dataset Information

Skin cancer projections and cost savings 2014-2045 of improvements to the Danish sunbed legislation of 2014.

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Skin cancer projections and cost savings 2014-2045 of improvements to the Danish sunbed legislation of 2014.

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