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Economic Analysis of Noninvasive Pathologic Assay

JAMA Dermatology; ePub 2018 Jul 11; Hornberger, et al

The pigmented lesion assay (PLA), a noninvasive gene expression test, reduces cost and may improve the care of patients with primary pigmented skin lesions suggestive of melanoma. This according to a recent study that sought to determine potential cost savings of PLA use vs the visual assessment followed by biopsy and histopathologic assessment (VAH) pathway. This health economic analysis was based on consensus treatment guidelines and fee schedules from the Centers for Medicare & Medicaid Services. Data were derived from routine use of the test in US dermatology practices and literature. Participants included patients with primary cutaneous pigmented lesions suggestive of melanoma. Researchers found:

  • In the cost analysis for this economic model, the relative reduction in surgical procedure costs, assuming $0 for the PLA to facilitate multiple comparison scenarios, was −$395 compared with VAH.
  • The relative reduction in stage-related treatment costs associated with the PLA was −$433 compared with VAH, primarily associated with avoidance of delays due to false-negative diagnoses.
  • Surveillance costs were reduced by −$119 with the PLA.
  • The total cost of fully adjudicating a lesion suggestive of melanoma by VAH was $947.


Hornberger J, Siegel DM. Economic analysis of a noninvasive molecular pathologic assay for pigmented skin lesions. [Published online ahead of print July 11, 2018]. JAMA Dermatology. doi:10.1001/jamadermatol.2018.1764.