Presentation (CTI)

OBJECTIVES: The primary objective of this assessment was to evaluate the cost-effectiveness of annual and biennial mammography compared to clinical breast examination for asymptomatic Filipino women aged 50-69 years old. The study also aimed to assess the budget impact over a five-year horizon.
METHODS: A Markov model with nine health states was utilized to simulate disease progression over a lifetime horizon. The study adopted a public payer perspective, with a 7% annual discount rate for both costs and outcomes. A five-year forecast was conducted to estimate the total costs and potential savings for the government based on the target population of women aged 50-69 years.
RESULTS: The study found that mammography, compared to CBE, provides additional health benefits and effectively reduces the long-term treatment costs associated with advanced stage disease. For the 1-year and 2-year simulation, mammography was more cost-effective than CBE with ICER of 23,547.26 per QALY gained and 32,766.94 per QALY gained, respectively. Both ICERs are considered cost-effective when assessed against the same WTP threshold of 1 GDP per capita. The budget impact analysis suggests that government will achieve long-term savings as screening services become more available, due to the reduced need for expensive late-stage cancer treatments. For the target population of women, the estimated five-year total cost for a scenario with 41.80% compliance is PHP 6.51 billion in Year 1, rising to PHP 6.94 billion by Year 5.
CONCLUSIONS: Mammography is the established standard for breast cancer screening and is highly recommended for women aged 50-60 years old. This evaluation provides evidence that implementing mammography screening in the Philippines is cost-effective and financially viable for the public payer over time.