Cost-Effectiveness Analysis of the Colorectal Cancer Screening Program Using Electronic Colonoscopy in Luohu, China
Author(s)
Ren Y1, Zhao M1, Zhou D1, Xing Q1, Gong F2, Tang W3
1China Pharmaceutical University, Nanjing, China, 2Shenzhen Luohu Hospital Group LuohuPeople's Hospital, Shenzhen, China, 3China Pharmaceutical University, Nanjing, 32, China
Presentation Documents
Objectives: This study aimed to evaluate the cost-effectiveness of the colon cancer screening program both implemented in Luohu District, Shenzhen of China among 2018-2021, and when scaled up to the national level. Methods: The cost-effectiveness of three screening protocols, including electronic colonoscopy (e-CSPY) every 10 years, e-CSPY every 5 years, and e-CSPY every 3 years, were compared with no screening, respectively, from the perspective of the Chinese health care system. A 12-state Markov model was developed to simulate a cohort of 100,000 individuals aging from 40 to 75 in Luohu undergoing from the screening to death. Clinical outcomes included the quality-adjusted life-year (QALY), number of cancers avoided, and number of deaths prevented, were calculated. We used incremental cost-effectiveness ratio (ICER) for each of the above outcomes for decision-making. Additionally, scenarios related to the national population, starting age (50) and different cancer treatment effectiveness were analyzed upon the base-case analysis. Results: The colon cancer screening program was generally cost-effective, and both 10-year and 5-year strategy had dominance over the non-screening strategy, saving 255.78 USD and 95.06 USD per capita and increasing QALYs by 0.472 and 0.605, respectively. And the ICER of the triennial screening strategy was 364.36 USD/QALY compared to no screening. Receiving screening at earlier age further decreased the ICER by 151.94–351.38 USD/QALY. Screening was also more cost-effective when the prevalence of high-risk adenomas was higher (8.07%), or treatment were not completely successful. Additionally, screening reduced cancer cases by 1,939–6,219 and deaths by 974–3,118 in all situations. Conclusion: Colon cancer screening using e-CSPY is cost-effective both in Luohu district and when scaled up to mainland China. The higher frequency of screening and earlier starting age are in favor of increased health benefits. Moreover, the earlier the starting age, the more cost-effectiveness the screening would bring.
Conference/Value in Health Info
2022-05, ISPOR 2022, Washington, DC, USA
Value in Health, Volume 25, Issue 6, S1 (June 2022)
Code
EE95
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
No Additional Disease & Conditions/Specialized Treatment Areas