OBJECTIVES

: assess the cost effectiveness of colonoscopy as a screening procedure against not performing the intervention in 50-year-old patients in a Colombian health insurer.

METHODS

: A cost-effectiveness analysis was developed under a decision tree model for the use of colonoscopy as a screening procedure from the perspective of a Colombian insurer. The clinical data of test sensitivity were obtained from published scientific literature. Outcomes of the model were the number of living patients at the end of the period of analysis (all life) and life years saved. Costs associated with the treatment of colon cancer by stage of the disease and the costs associated with the intervention were included. A Monte Carlo probabilistic sensitivity analysis with 1,000 iterations was developed.

RESULTS

: it was estimated that to detect a positive case of colon cancer, it is necessary to perform 137 screening colonoscopies, which generates a total cost of COP $ 37,250,830.26 and 0.98 live patients, with an ICER of COP $ 48,937,330.49; Likewise, the use of colonoscopy generates 25.64 LYS compared to 22.47 LYS when it is not performed, with an ICER of COP $ 1,882,205, a cost that the insurer should invest in the diagnosis of colon cancer per life year saved.

CONCLUSIONS

: colonoscopy as a screening method for colon cancer in people over 50 years old is a cost effective strategy in mandatory health insurance with an ICER of COP $ 48,937,989.96 and a greater number of years of life saved compared to not doing intervention with an ICER of COP $ 1,882,230; however, these values could exceed the threshold expected by the Colombian insurance model.