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

Background: 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.

Aim: To compare costs for patients diagnosed with skin cancer with preceding rSCS vs. those diagnosed without rSCS.

Methods: 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.

Results: In total, 12 790 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.

Conclusions: Based on our analysis, rSCS has the potential to reduce treatment costs; however, the screening costs exceed these savings.