Budget Impact of Low-Dose Computed Tomography Screening for Lung Cancer in Argentina

OBJECTIVES: Lung cancer (LC) is a leading cause of cancer mortality in Argentina, representing 1.4% of the country's healthcare expenditure. In this regard, more efficient prevention programs are required. The National Lung Screening Trial demonstrated the higher efficacy of low-dose computed tomography (LDCT) instead of chest radiography as a screening method to detect cases at an early stage and prevent LC mortality. This study aims to estimate a Budget Impact Analysis (BIA) for implementing annual LDCT screening in individuals aged 55 to 74 with a smoking history of at least 30 pack-years in Argentina.

METHODS: A budgetary impact model was developed for a dynamic cohort, from the perspective of the whole argentine health system. The model considers incident cases, prevalent cases and probability of death, distinguishing by disease stage and years of survival. The model parameters were obtained through a literature review and official databases. The costs are expressed in 2023 US dollars (USD).

RESULTS: From a population of 46 million people in Argentina, the annual eligible population for LC screening was 726,420 individuals per year. The study estimated that incorporating LDCT as a screening measure represents an average annual incremental cost of 7.43% of the Argentine’s health system budget, primarily driven by LDCT costs, followed by diagnosis costs due to a higher number of false positives in LDCT. The budget impact per-member-per-month was USD 0.023, below the estimated budget impact threshold of USD 5.44.

CONCLUSIONS: The introduction of LDCT for LC screening presented a slight incremental cost in the national health system budget in Argentina, and showed an improvement in detection of the disease at early stages.