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.