Cancer Research and Treatment

Original Articles

Lung and Thoracic cancer

Cost Utility Analysis of a Pilot Study for the Korean Lung Cancer Screening Project: Juyoung Kim, Bogeum Cho, Seon-Ha Kim, Chang-Min Choi, Yeol Kim, Min-Woo Jo; Cancer Res Treat. 2022;54(3):728-736. Published online September 24, 2021; DOI: https://doi.org/10.4143/crt.2021.480

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Purpose
The aim of this study was to evaluate the cost utility of a pilot study of Korean Lung Cancer Screening Project.
Materials and Methods
We constructed a Markov model consisting of 26 states based on the natural history of lung cancer according to the Surveillance, Epidemiology, and End Results summary stage (localized, regional, distant). In the base case, people aged 55-74 years were under consideration for annual screening. Costs and quality-adjusted life years were simulated to calculate the incremental cost utility ratio. Sensitivity analyses were performed on the uncertainty associated with screening target ages, stage distribution, cost, utility, mortality, screening duration, and discount rate.
Results
The base case (US$25,383 per quality-adjusted life year gained) was cost-effective compared to the scenario of no screening and acceptable considering a willingness-to-pay threshold of US$27,000 per quality-adjusted life years gained. In terms of the target age of screening, the age between 60 and 74 years was the most cost-effective. Lung cancer screening was still cost-effective in the sensitivity analyses on the cost for treatment, utility, mortality, screening duration, and less than 5% discount rates, although the result was sensitive to a rise in positive rates or variation of stage distribution.
Conclusion
Our results showed the cost-effectiveness of annual low-dose computed tomography screening for lung cancer in high-risk populations.

Citations

Citations to this article as recorded by

Quantitative risk factor analysis of prior disease condition and socioeconomic status with the multiple myeloma development: nationwide cohort study
Suein Choi, Eunjin Kim, Jinhee Jung, Sung-Soo Park, Chang-Ki Min, Seunghoon Han
Scientific Reports.2024;[Epub] CrossRef
Survival of lung cancer patients according to screening eligibility using Korean Lung Cancer Registry 2014–2016
Sangwon Lee, Eun Hye Park, Bo Yun Jang, Ye Ji Kang, Kyu-Won Jung, Hyo Soung Cha, Kui Son Choi
Scientific Reports.2024;[Epub] CrossRef
Cost-Effectiveness Analysis of Risk Factor-Based Lung Cancer Screening Program by Low-Dose Computer Tomography in Current Smokers in China
Tiantian Zhang, Xudong Chen, Caichen Li, Xiaoqin Wen, Tengfei Lin, Jiaxing Huang, Jianxing He, Nanshan Zhong, Jie Jiang, Wenhua Liang
Cancers.2023; 15(18): 4445. CrossRef
Applying utility values in cost-effectiveness analyses of lung cancer screening: a review of methods
Preston J. Ngo, Sonya Cressman, Silvia Behar-Harpaz, Deme J. Karikios, Karen Canfell, Marianne F. Weber
Lung Cancer.2022;[Epub] CrossRef
Cost-Effectiveness Analyses of Lung Cancer Screening Using Low-Dose Computed Tomography: A Systematic Review Assessing Strategy Comparison and Risk Stratification
Matthew Fabbro, Kirah Hahn, Olivia Novaes, Mícheál Ó’Grálaigh, James F. O’Mahony
PharmacoEconomics - Open.2022; 6(6): 773. CrossRef

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Strategic Distributional Cost-Effectiveness Analysis for Improving National Cancer Screening Uptake in Cervical Cancer: A Focus on Regional Inequality in South Korea: Tae-Hoon Lee, Woorim Kim, Jaeyong Shin, Eun-Cheol Park, Sohee Park, Tae Hyun Kim; Cancer Res Treat. 2018;50(1):212-221. Published online March 30, 2017; DOI: https://doi.org/10.4143/crt.2016.525

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to conduct a cost effectiveness analysis of strategies designed to improve national cervical cancer screening rates, along with a distributional cost effectiveness analysis that considers regional disparities.
Materials and Methods
Cost effectiveness analysis was conducted using a Markov cohort simulation model, with quality adjusted life years as the unit of effectiveness. The strategies considered were current (biennial Papanicolaou smear cytology of females aged 20 or above), strong screening recommendation by mail to target regions (effect, 12% increase in screening uptake; cost, 1,000 Korean won per person), regular universal screening recommendation by mail (effect, 6% increase in screening uptake; cost, 500 Korean won per person), and strong universal screening recommendation by mail (effect, 12% increase in screening uptake; cost, 1,000 Korean won per person). Distributional cost effectiveness analysis was conducted by calculating the cost effectiveness of strategies using the Atkinson incremental cost effectiveness ratio.
Results
All strategies were under the threshold value, which was set as the Korean gross domestic product of $25,990. In particular, the ‘strong screening recommendation to target regions’ strategy was found to be the most cost effective (incremental cost effectiveness ratio, 7,361,145 Korean won). This was also true when societal inequality aversion increased in the distributional cost effectiveness analysis.
Conclusion
The ‘strong screening recommendation to target regions’ strategy was the most cost effective approach, even when adjusting for inequality. As efficiency and equity are objectives concurrently sought in healthcare, these findings imply a need to develop appropriate economic evaluation methodologies to assess healthcare policies.

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Economic Evaluations of Interventions Addressing Inequalities in Cancer Care: A Systematic Review
Bedasa Taye Merga, Nikki McCaffrey, Suzanne Robinson, Ebisa Turi, Anita Lal
Value in Health.2024;[Epub] CrossRef
Incorporating Equity Concerns in Cost-Effectiveness Analyses: A Systematic Literature Review
Thomas Ward, Ruben E. Mujica-Mota, Anne E. Spencer, Antonieta Medina-Lara
PharmacoEconomics.2022; 40(1): 45. CrossRef
Incorporating health equity into value assessment: frameworks, promising alternatives, and future directions
Vakaramoko Diaby, Askal Ali, Aram Babcock, Joseph Fuhr, Dejana Braithwaite
Journal of Managed Care & Specialty Pharmacy.2021; 27(9-a Suppl): S24. CrossRef
Incorporating health equity into value assessment: frameworks, promising alternatives, and future directions
Vakaramoko Diaby, Askal Ali, Aram Babcock, Joseph Fuhr, Dejana Braithwaite
Journal of Managed Care & Specialty Pharmacy.2021; 27(9-a Suppl): S22. CrossRef

9,710 View
274 Download
2 Web of Science
4 Crossref

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