A recent study evaluated the potential savings to health plans when the pigmented lesion assay (PLA) is incorporated into the assessment of pigmented lesions clinically suspicious for melanoma. 

The researchers developed aReturn on Investment (ROI) model from a US payor perspective to determine theper member per month (PMPM) net savings impact of incorporating PLA into the visual assessment/histopathology (VAH) pathway. Data of patients with lesions suspicious of melanoma (N=2,39,854) was employed to model the use of PLA in year 1, which was followed through subsequent years. Costs were estimated via the pathway of initial visual assessment, surgical procedure(s), histopathology and subsequent management.

The results were as follows:

• The ROI model anticipated annual net savings of $0.54 PMPM for commercial health plans over 3 years with the incorporation of PLA into the VAH pathway.
• This analysis diagnosed 95.7% of surgically assessed lesions clinically suspicious for melanoma as benign, with 30.4% of patients with benign lesions experiencing a more advanced procedure (e.g., excision), either initially or following a biopsy.
• Melanoma diagnosis rates associated with biopsy only, excision only and biopsy followed by excision procedures in the VAH pathway was found to be 0.9%, 0.1% and 17.9%, respectively.

Thus, incorporating the PLA into the VAH pathway for the assessment of suspicious pigmented lesions causes savings for commercial health insurance plans. Using the PLA improves patient care by using genomic assessments to minimize avoidable surgical procedures on benign lesions, enrich the population of melanomas diagnosed and decrease downstream costs of late-stage melanoma diagnoses.

Source: Siegel DM, Murphy C, Wangsness KD, et al. Cost-benefit analysis of the pigmented lesion assay when introduced into the visual assessment/histopathology pathway for lesions clinically suspicious for melanoma. SKIN. 2022;6(2):109-21.