Economic burden of Melanoma in Oregon to Inform State-wide Early Detection initiatives, The War on Melanoma

Melanoma imposes substantial clinical and financial burdens, particularly in advanced stages where systemic therapies are increasingly utilized. To establish a baseline for evaluating the statewide War on Melanoma (WoM) early detection initiative, we analyzed stage-specific melanoma expenditures in Oregon from 2011-2021 using a novel pseudostaging algorithm applied to the Oregon All Payer All Claims (APAC) database. The algorithm classified cases into early (in situ/localized), regional, and distant stages based on diagnostic, procedural, and treatment codes and was validated against SEER-Medicare claims and chart review. Over the study period, the number of melanoma cases in claims rose steadily, and total annual expenditures tripled, driven primarily by late-stage disease. Expenditures for early-stage melanoma remained relatively stable, while costs for regional and distant stages increased sharply with the adoption of immune checkpoint inhibitors and targeted therapies. These findings provide the first comprehensive, claims-based baseline of stage-specific melanoma costs in Oregon and highlight the disproportionate economic burden of advanced disease. Establishing such baselines is critical for evaluating population-level initiatives like WoM and for assessing the potential economic benefits of earlier detection and treatment. SummaryO_LIWe quantified the stage-specific economic burden of melanoma in Oregon using a pseudostaging algorithm applied to statewide claims data, demonstrating sharp increases in cost, particularly in advanced disease. C_LIO_LIThese estimates provide essential baseline evidence for evaluating the War on Melanoma, a statewide initiative designed to promote earlier detection and reduce the need for costly late-stage treatment. C_LIO_LIThe reproducible claims-based approach offers a scalable framework for other states and health systems to assess the value of cancer prevention and early detection initiatives. C_LI SignificanceWe establish stage-specific costs of melanoma in Oregon using a validated claims-based pseudostaging algorithm. The results highlight the disproportionate financial burden of advanced disease and provide essential context for the War on Melanoma, a statewide early detection initiative. These baseline estimates enable rigorous evaluation of whether shifting toward earlier-stage diagnosis can reduce healthcare costs and improve patient outcomes, offering a framework relevant to other states and cancer prevention programs.