Abstract

BACKGROUND: The use of indoor tanning devices causes melanoma and other skin cancers with resulting morbidity, mortality and increased healthcare costs. Policy-makers require robust economic evidence to inform decisions about a possible ban of such devices to mitigate these burdens. OBJECTIVES: To assess the health costs and consequences of introducing a policy-based intervention across England to ban commercial indoor tanning with an accompanying public information campaign. METHODS: A cost-effectiveness analysis, adopting a healthcare system perspective, was conducted using a decision-model to track a national cohort of 18-year-olds over a lifetime time horizon. A nationwide ban on commercial indoor tanning combined with a public information campaign (the policy-based intervention) was compared with the status quo of availability of commercial indoor tanning. The expected costs (currency: GBP, price year: 2019) and Quality Adjusted Life Years (QALYs) were calculated. Net Monetary Benefit (NMB; net benefit measured in cost compared to an accepted threshold) and Net Health Benefit (NHB; net gain in QALYs compared to an accepted threshold) of implementation were calculated. A probabilistic sensitivity analysis was used to calculate the probability the intervention was cost-effective. RESULTS: Compared to the current situation, a ban on commercial indoor tanning combined with a public information campaign would result in 1,206 avoided cases of melanoma, 207 fewer melanoma deaths, and 3,987 averted cases of keratinocyte cancers over the lifetime of all 18-year-olds (n=618,873) living in England in 2019. An additional 497 QALYs would be realised along with healthcare cost-savings of £697,858. This intervention would result in an NMB of £10.6m and a NHB of 530 QALYS. Multiple sensitivity analyses confirmed the robustness of findings. At a cost-effectiveness threshold of £20,000, there is a 99% likelihood of this policy-based intervention being cost-effective. CONCLUSIONS: The implementation of a ban on commercial indoor tanning across England with an accompanying public information campaign would be an effective use of healthcare resources.

Authors	Eden, Martin; Hainsworth, Rob; Gordon, Louisa G; Epton, Tracy; Lorigan, Paul; Rhodes, Lesley E; Marais, Richard; Green, Adele C; Payne, Katherine
Journal	BRITISH JOURNAL OF DERMATOLOGY
Pages	105-114
Volume	187
Date	1/01/2022
Grant ID
Funding Body
URL	http://www.ncbi.nlm.nih.gov/pubmed/?term=10.1111/bjd.21046