Extension of the Mammographic Screening Program in Italy: Cost-Benefit Analysis and Impact of Early Diagnosis in the 45-74 Age Group
Author(s)
Eugenio Di Brino1, Michele Basile, Sr., Health Economics2, Filippo Rumi, MA, MSc3.
1Co-Founder & Partner, Altems Advisory, Università Cattolica del Sacro Cuore, Roma, Italy, 2Altems Advisory, Università Cattolica del Sacro Cuore, Roma, Rome, Italy, 3Altems Advisory, Università Cattolica del Sacro Cuore, Roma, Italy.
1Co-Founder & Partner, Altems Advisory, Università Cattolica del Sacro Cuore, Roma, Italy, 2Altems Advisory, Università Cattolica del Sacro Cuore, Roma, Rome, Italy, 3Altems Advisory, Università Cattolica del Sacro Cuore, Roma, Italy.
OBJECTIVES: This study aims to assess the economic and health impact of extending Italy’s mammography screening program to include women aged 45 to 74. The goal is to evaluate the cost-benefit ratio of this expansion, based on evidence regarding early diagnosis, efficient resource allocation, and territorial equity, within a framework of long-term sustainability for the National Health Service (NHS).
METHODS: The analysis was conducted in two phases. The first involved estimating the eligible population through a review of regional guidelines and updated demographic data from ISTAT. The second phase developed an economic model based on a decision tree, incorporating direct costs of mammograms (€34.86 per exam) and associated costs of further diagnostic procedures (ultrasound, biopsy, MRI). Two scenarios were compared: the current situation (AS IS), in which only some regions have extended coverage, and a potential nationwide implementation (TO BE).
RESULTS: The proposed extension would involve 3,894,331 women, with a total estimated investment of €135.7 million. Currently, 2,040,097 women are covered by extended regional programs, while 1,854,234 remain excluded. In the AS IS scenario, the total cost amounts to €45.3 million with 8,998 cases detected; in the TO BE scenario, the cost is slightly lower at €42.9 million, with 8,529 cases detected and savings due to earlier disease management. The cost of treating advanced-stage cancers is significantly reduced in the extended scenario (€42.6 million vs. €44.9 million), resulting in a net benefit of €35 million.
CONCLUSIONS: Incorporating this screening into the Essential Levels of Care (LEA) would promote equity and sustainability, improving patients’ quality of life and optimizing NHS resources.
METHODS: The analysis was conducted in two phases. The first involved estimating the eligible population through a review of regional guidelines and updated demographic data from ISTAT. The second phase developed an economic model based on a decision tree, incorporating direct costs of mammograms (€34.86 per exam) and associated costs of further diagnostic procedures (ultrasound, biopsy, MRI). Two scenarios were compared: the current situation (AS IS), in which only some regions have extended coverage, and a potential nationwide implementation (TO BE).
RESULTS: The proposed extension would involve 3,894,331 women, with a total estimated investment of €135.7 million. Currently, 2,040,097 women are covered by extended regional programs, while 1,854,234 remain excluded. In the AS IS scenario, the total cost amounts to €45.3 million with 8,998 cases detected; in the TO BE scenario, the cost is slightly lower at €42.9 million, with 8,529 cases detected and savings due to earlier disease management. The cost of treating advanced-stage cancers is significantly reduced in the extended scenario (€42.6 million vs. €44.9 million), resulting in a net benefit of €35 million.
CONCLUSIONS: Incorporating this screening into the Essential Levels of Care (LEA) would promote equity and sustainability, improving patients’ quality of life and optimizing NHS resources.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HPR87
Topic
Economic Evaluation, Epidemiology & Public Health, Health Policy & Regulatory
Topic Subcategory
Health Disparities & Equity
Disease
Oncology