OBJECTIVES: Budget impact analyses (BIA) assess the financial consequences of the implementation of new health care technologies. BIAs are increasingly required by decision makers for budgetary planning. Our study aims to systematically review published BIA, applied methods and if international BIA guidelines are followed in evaluating cancer screening programs.

METHODS: A systematic literature search was conducted in MEDLINE and EconLit for BIA evaluating cancer screening programs, published in English language 2010-2016. Standardized evidence tables were used to extract main characteristics of the analysis and model along the ISPOR BIA Task Force guidelines including cancer type, model structure, definition of population size/characteristics, perspective, time horizon, included costs, source of epidemiologic and clinical data, consideration of health impact, validation, and uncertainty analysis.

RESULTS: Ten studies were identified. Three studies evaluated screening for breast cancer, two for colorectal and cervical cancer and one for lung, prostate and skin cancers. Model designs varied from several types of decision-analytic models (60%) to simple cost calculators (40%). The ISPOR guidelines recommend using a simple BIA model structure such as a cost calculator approach as long as important conditions are credibly captured. The time horizon ranged from one to 20 years; six studies applied a one-year time horizon. Projections beyond one year are recommended by ISPOR guidelines, because cost and population parameters might change. All studies included direct condition-related costs and two studies additionally included indirect cost. Health impact was reported in 40% of the studies. Uncertainty analysis was not always sufficiently reported. Only 40% of the studies reported validation to some extent.

CONCLUSIONS: BIA studies evaluating cancer screening programs show a substantial variability in the scope of guidelines consideration. Applied time horizon, reporting validation and uncertainty analysis are areas for improvement. Best practice recommendations need to be followed for assisting sound health plan decision making.