| Autor: |
Ten Berge H; Institute for Diagnostic Accuracy, 9713 GH Groningen, The Netherlands., Ramaker D; Institute for Diagnostic Accuracy, 9713 GH Groningen, The Netherlands., Piazza G; Institute for Diagnostic Accuracy, 9713 GH Groningen, The Netherlands., Pan X; Institute for Diagnostic Accuracy, 9713 GH Groningen, The Netherlands.; Unit of Global Health, Faculty of Medical Sciences, University of Groningen, 9713 GZ Groningen, The Netherlands., Lamprecht B; Department of Pulmonary Medicine, Kepler University Hospital, 4020 Linz, Austria.; Medical Faculty, Johannes Kepler University, 4040 Linz, Austria., Valipour A; Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, 1210 Vienna, Austria., Prosch H; Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna General Hospital, 1090 Vienna, Austria. |
| Abstrakt: |
This study assessed the cost-effectiveness of a lung cancer screening (LCS) program using low-dose computed tomography (LDCT) in Austria. An existing decision tree with an integrated Markov model was used to analyze the cost-effectiveness of LCS versus no screening from a healthcare payer perspective over a lifetime horizon. A simulation was conducted to model annual LCS for an asymptomatic high-risk population cohort aged 50-74 with a smoking history using the Dutch-Belgian Lung Cancer Screening Study (NEderlands-Leuvens Longkanker ScreeningsONderzoek, NELSON) screening outcomes. The principal measure utilized to assess cost-effectiveness was the incremental cost-effectiveness ratio (ICER). Sensitivity and scenario analyses were employed to determine uncertainties surrounding the key model inputs. At an uptake rate of 50%, 300,277 eligible individuals would participate in the LCS program, yielding 56,122 incremental quality-adjusted life years (QALYs) and 84,049 life years gained compared to no screening, with an ICER of EUR 24,627 per QALY gained or EUR 16,444 per life-year saved. Additionally, LCS led to the detection of 25,893 additional early-stage lung cancers and averted 11,906 premature lung cancer deaths. It was estimated that LCS would incur EUR 945 million additional screening costs and EUR 386 million additional treatment costs. These estimates were robust in sensitivity analyses. Implementation of annual LCS with LDCT for a high-risk population, using the NELSON screening outcomes, is cost-effective in Austria, at a threshold of EUR 50,000 per QALY. |
