Cost-Effectiveness of LGI-Flag in Austria: A Model-Based Evaluation
Author(s)
Evelyn Walter, PhD1, Christian Datz, MD2, Atilla Kaya, Mag.3, Hans Georg Mustafa, MD4.
1CEO, Institute for Pharmacoeconomic Research, Vienna, Austria, 2Krankenhaus Oberndorf, Salzburg, Austria, 3Roche Diagnostics GmbH, Vienna, Austria, 4Labor für Medizinisch Chemische und mikrobiologische Diagnostik GmbH, Salzburg, Austria.
1CEO, Institute for Pharmacoeconomic Research, Vienna, Austria, 2Krankenhaus Oberndorf, Salzburg, Austria, 3Roche Diagnostics GmbH, Vienna, Austria, 4Labor für Medizinisch Chemische und mikrobiologische Diagnostik GmbH, Salzburg, Austria.
OBJECTIVES: Colorectal cancer (CRC) remains a leading cause of cancer-related morbidity and mortality. In Austria, CRC is the third most common cancer in men and the second in women, with approximately 4,500 new cases annually. Late-stage diagnoses contribute to significant economic burden. Early detection is critical for improving outcomes and reducing costs. LGI-Flag, an AI-based risk stratification tool using routine blood test data, may enhance early CRC detection and screening adherence. However, its cost-effectiveness in the Austrian healthcare context has not yet been thoroughly assessed.
METHODS: A decision-analytic cohort simulation model was developed to assess CRC progression (UICC stages I-IV) over a lifetime horizon, based on Austrian epidemiological data. The model incorporated real-world screening adherence and compared six strategies starting at age 45: (1) annual LGI-Flag, (2) LGI-Flag after negative FIT, (3) LGI-Flag after negative Hemoccult, (4) annual FIT + LGI-Flag, (5) annual Hemoccult + LGI-Flag, and (6) no screening. Outcomes included life-years (LYs), quality-adjusted life-years (QALYs), and positive test results. Probabilities and utilities were drawn from published literature; costs were based on Austrian data. Results were expressed as incremental cost-effectiveness ratios (ICERs) from a societal perspective, with sensitivity analyses conducted to address uncertainty.
RESULTS: The LGI-Flag-based screening yields a total cost of €1,504.97 per person screened (€625.02 direct, €879,95 indirect), while no screening costs €3,234.03. LGI-Flag provides an incremental gain of 0.10 QALYs and is dominant over no screening. Costs for alternative strategies range from €1,195.59 to €1,630.53. Strategies that include LGI-Flag remain the most cost-effective. Detection rates are highest when LGI-Flag follows a negative FIT or is combined with FIT.
CONCLUSIONS: LGI-Flag is a cost-effective and dominant screening strategy for CRC in Austria. Its integration—especially following negative FIT or in combination with FIT—offers potential to improve early detection while reducing long-term healthcare and societal costs.
METHODS: A decision-analytic cohort simulation model was developed to assess CRC progression (UICC stages I-IV) over a lifetime horizon, based on Austrian epidemiological data. The model incorporated real-world screening adherence and compared six strategies starting at age 45: (1) annual LGI-Flag, (2) LGI-Flag after negative FIT, (3) LGI-Flag after negative Hemoccult, (4) annual FIT + LGI-Flag, (5) annual Hemoccult + LGI-Flag, and (6) no screening. Outcomes included life-years (LYs), quality-adjusted life-years (QALYs), and positive test results. Probabilities and utilities were drawn from published literature; costs were based on Austrian data. Results were expressed as incremental cost-effectiveness ratios (ICERs) from a societal perspective, with sensitivity analyses conducted to address uncertainty.
RESULTS: The LGI-Flag-based screening yields a total cost of €1,504.97 per person screened (€625.02 direct, €879,95 indirect), while no screening costs €3,234.03. LGI-Flag provides an incremental gain of 0.10 QALYs and is dominant over no screening. Costs for alternative strategies range from €1,195.59 to €1,630.53. Strategies that include LGI-Flag remain the most cost-effective. Detection rates are highest when LGI-Flag follows a negative FIT or is combined with FIT.
CONCLUSIONS: LGI-Flag is a cost-effective and dominant screening strategy for CRC in Austria. Its integration—especially following negative FIT or in combination with FIT—offers potential to improve early detection while reducing long-term healthcare and societal costs.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE241
Topic
Clinical Outcomes, Economic Evaluation, Medical Technologies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology