Cost-Effectiveness of Lung Cancer Screening with Low Dose Computed Tomography in Hungary
Author(s)
Nagy B1, Szilberhorn L2, Győrbíró D2, Moizs M3, Bajzik G4, Kerpel-Fronius A5, Vokó Z2
1Syreon Research Institute, Budapest, PE, Hungary, 2Syreon Research Institute, Budapest, Hungary, 3Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary, 4Kaposvár University Health Center, Kaposvár, Hungary, 5National Korányi Institute for Pulmonology, Budapest, Hungary
OBJECTIVES: Clinical and economic data support the use of low dose computed tomography (LDCT) to screen patients with high risk of lung cancer. This study aims to explore the economic value of screening lung cancer with LDCT in Hungary.
METHODS: Cohorts of screened and non-screened subjects were simulated in a decision-analytic model over their lifetime. Five steps in the patient trajectory were distinguished: no lung cancer, non-diagnosed lung cancer, screening, diagnosed lung cancer and post-operation state. Patient pathways were populated based on the HUNCHEST study, the NELSON lung cancer screening trial and local incidence and prevalence data. Healthcare costs were obtained from the National Health Insurance Fund. Utility data were obtained from international sources and adjusted to local tariffs. Scenarios according to screening frequency, age-bands (50-74, 55-74) and smoking status were analysed.
RESULTS: Annual LDCT-based screening compared to no screening for 55-74 year-old smokers showed 0.078 Quality Adjusted Life Year (QALY) gains for an additional 245 Euros which yields an incremental cost-effectiveness ratio (ICER) of 3 153 € per QALY. Biennial screening for the same target population showed that an additional QALY would cost 6,718 €. The least efficient case was biennial screening of the general population aged 50-74, which yielded and ICER of 22 204 € per QALY, a value above the willingness-to-pay threshold in Hungary.
CONCLUSIONS: Screening lung cancer with LDCT for a high-risk population is projected to be cost-effective in Hungary. For the introduction of screening with LDCT, targeting the most vulnerable groups while having a long-term approach on costs and benefits is essential.
Conference/Value in Health Info
Value in Health, Volume 25, Issue 12S (December 2022)
Code
EE325
Topic
Economic Evaluation, Epidemiology & Public Health, Medical Technologies, Methodological & Statistical Research
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis, Diagnostics & Imaging, Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas
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