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Updated cost-effectiveness analysis of lung cancer screening for Australia, capturing differences in the health economic impact of NELSON and NLST outcomes

Behar Harpaz, Silvia ; Weber, Marianne F ; Wade, Stephen ; Ngo, Preston J ; Vaneckova, Pavla ; Sarich, Peter E A ; Cressman, Sonya ; Tammemagi, Martin C ; Fong, Kwun ; Marshall, Henry ; McWilliams, Annette ; Zalcberg, John R ; Caruana, Michael ; Canfell, Karen

British journal of cancer, 2023-01, Vol.128 (1), p.91-101 [Periódico revisado por pares]

England: Nature Publishing Group

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Título:
Updated cost-effectiveness analysis of lung cancer screening for Australia, capturing differences in the health economic impact of NELSON and NLST outcomes
Autor: Behar Harpaz, Silvia ; Weber, Marianne F ; Wade, Stephen ; Ngo, Preston J ; Vaneckova, Pavla ; Sarich, Peter E A ; Cressman, Sonya ; Tammemagi, Martin C ; Fong, Kwun ; Marshall, Henry ; McWilliams, Annette ; Zalcberg, John R ; Caruana, Michael ; Canfell, Karen
Assuntos: Australia - epidemiology ; Cancer screening ; Clinical Trials as Topic ; Cost analysis ; Cost-Effectiveness Analysis ; Early Detection of Cancer - economics ; Humans ; Lung cancer ; Lung Neoplasms - diagnosis ; Medical screening ; Mortality ; Quality-Adjusted Life Years ; Sensitivity analysis
É parte de: British journal of cancer, 2023-01, Vol.128 (1), p.91-101
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Descrição: A national, lung cancer screening programme is under consideration in Australia, and we assessed cost-effectiveness using updated data and assumptions. We estimated the cost-effectiveness of lung screening by applying screening parameters and outcomes from either the National Lung Screening Trial (NLST) or the NEderlands-Leuvens Longkanker Screenings ONderzoek (NELSON) to Australian data on lung cancer risk, mortality, health-system costs, and smoking trends using a deterministic, multi-cohort model. Incremental cost-effectiveness ratios (ICERs) were calculated for a lifetime horizon. The ICER for lung screening compared to usual care in the NELSON-based scenario was AU$39,250 (95% CI $18,150-108,300) per quality-adjusted life year (QALY); lower than the NLST-based estimate (ICER = $76,300, 95% CI $41,750-236,500). In probabilistic sensitivity analyses, lung screening was cost-effective in 15%/60% of NELSON-like simulations, assuming a willingness-to-pay threshold of $30,000/$50,000 per QALY, respectively, compared to 0.5%/6.7% for the NLST. ICERs were most sensitive to assumptions regarding the screening-related lung cancer mortality benefit and duration of benefit over time. The cost of screening had a larger impact on ICERs than the cost of treatment, even after quadrupling the 2006-2016 healthcare costs of stage IV lung cancer. Lung screening could be cost-effective in Australia, contingent on translating trial-like lung cancer mortality benefits to the clinic.
Editor: England: Nature Publishing Group
Idioma: Inglês

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Updated cost-effectiveness analysis of lung cancer screening for Australia, capturing differences in the health economic impact of NELSON and NLST outcomes

Behar Harpaz, Silvia ; Weber, Marianne F ; Wade, Stephen ; Ngo, Preston J ; Vaneckova, Pavla ; Sarich, Peter E A ; Cressman, Sonya ; Tammemagi, Martin C ; Fong, Kwun ; Marshall, Henry ; McWilliams, Annette ; Zalcberg, John R ; Caruana, Michael ; Canfell, Karen

England: Nature Publishing Group

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