An indirect approach to identify the healthcare services for thyroid and melanoma cancer patients in Italy: Epicost-2 project

Introduction: An indirect approach was applied to the case-study of thyroid cancer (TC) and melanoma of the skin (MS) in Italy to identify health services (HS) for cancer patients and to enable cost estimation. Materials and methods: Within the Epicost-2 project, a self-controlled crossover design analysed TC and MS 2018 prevalent cases from Italian cancer registries. Controls (1:1) were matched to cases 18-6 months prior to diagnosis; increases between cases and controls in potentially cancer-related HS claims (P⩽5%) were identified. Validation: Oncology and clinical experts validated cancer-related HS lists using statistical, clinical, and economic criteria. Results: The approach identified 202 and 333 cancer-related HS codes for TC and MS, respectively, aligned with clinical pathways. Discussion: The indirect approach reduced validation workload by 75% versus direct one. Conclusion: The approach identifies the costs of cancer care that could also be reproduced in other countries with consistent results, and the approach applied to other cancers.