Economic evaluation of the breast cancer screening programme in the Basque Country: retrospective cost-effectiveness and budget impact analysis.

BACKGROUND: Breast cancer screening in the Basque Country has shown 20 % reduction of the number of BC deaths and an acceptable overdiagnosis level (4 % of screen detected BC). The aim of this study was to evaluate the breast cancer early detection programme in the Basque Country in terms of retrosp...

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Autores: Arrospide, Arantzazu, Rué, Montserrat, Van Ravesteyn, Nicolien T., Comas Serrano, Mercè, Soto-Gordoa, Myriam, Sarriugarte, Garbiñe, Mar, Javier
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2016
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/26984
Acceso en línea:http://hdl.handle.net/10230/26984
http://dx.doi.org/10.1186/s12885-016-2386-y
Access Level:acceso abierto
Palabra clave:Mama -- Càncer -- Espanya
Cost-eficàcia
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spelling Economic evaluation of the breast cancer screening programme in the Basque Country: retrospective cost-effectiveness and budget impact analysis.Arrospide, ArantzazuRué, MontserratVan Ravesteyn, Nicolien T.Comas Serrano, MercèSoto-Gordoa, MyriamSarriugarte, GarbiñeMar, JavierMama -- Càncer -- EspanyaCost-eficàciaBACKGROUND: Breast cancer screening in the Basque Country has shown 20 % reduction of the number of BC deaths and an acceptable overdiagnosis level (4 % of screen detected BC). The aim of this study was to evaluate the breast cancer early detection programme in the Basque Country in terms of retrospective cost-effectiveness and budget impact from 1996 to 2011. METHODS: A discrete event simulation model was built to reproduce the natural history of breast cancer (BC). We estimated for lifetime follow-up the total cost of BC (screening, diagnosis and treatment), as well as quality-adjusted life years (QALY), for women invited to participate in the evaluated programme during the 15-year period in the actual screening scenario and in a hypothetical unscreened scenario. An incremental cost-effectiveness ratio was calculated with the use of aggregated costs. Besides, annual costs were considered for budget impact analysis. Both population level and single-cohort analysis were performed. A probabilistic sensitivity analysis was applied to assess the impact of parameters uncertainty. RESULTS: The actual screening programme involved a cost of 1,127 million euros and provided 6.7 million QALYs over the lifetime of the target population, resulting in a gain of 8,666 QALYs for an additional cost of 36.4 million euros, compared with the unscreened scenario. Thus, the incremental cost-effectiveness ratio was 4,214€/QALY. All the model runs in the probabilistic sensitivity analysis resulted in an incremental cost-effectiveness ratio lower than 10,000€/QALY. The screening programme involved an increase of the annual budget of the Basque Health Service by 5.2 million euros from year 2000 onwards. CONCLUSIONS: The BC screening programme in the Basque Country proved to be cost-effective during the evaluated period and determined an affordable budget impact. These results confirm the epidemiological benefits related to the centralised screening system and support the continuation of the programme.This study was funded by the grant 2010111007 from the Health Department of the Basque Government.BioMed Central201620162016info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/26984http://dx.doi.org/10.1186/s12885-016-2386-yreponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésBMC Cancer. 2016 Jun 1;16(1):344© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0/nInternational License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and/nreproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to/nthe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver/n(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/269842026-06-12T07:21:37Z
dc.title.none.fl_str_mv Economic evaluation of the breast cancer screening programme in the Basque Country: retrospective cost-effectiveness and budget impact analysis.
title Economic evaluation of the breast cancer screening programme in the Basque Country: retrospective cost-effectiveness and budget impact analysis.
spellingShingle Economic evaluation of the breast cancer screening programme in the Basque Country: retrospective cost-effectiveness and budget impact analysis.
Arrospide, Arantzazu
Mama -- Càncer -- Espanya
Cost-eficàcia
title_short Economic evaluation of the breast cancer screening programme in the Basque Country: retrospective cost-effectiveness and budget impact analysis.
title_full Economic evaluation of the breast cancer screening programme in the Basque Country: retrospective cost-effectiveness and budget impact analysis.
title_fullStr Economic evaluation of the breast cancer screening programme in the Basque Country: retrospective cost-effectiveness and budget impact analysis.
title_full_unstemmed Economic evaluation of the breast cancer screening programme in the Basque Country: retrospective cost-effectiveness and budget impact analysis.
title_sort Economic evaluation of the breast cancer screening programme in the Basque Country: retrospective cost-effectiveness and budget impact analysis.
dc.creator.none.fl_str_mv Arrospide, Arantzazu
Rué, Montserrat
Van Ravesteyn, Nicolien T.
Comas Serrano, Mercè
Soto-Gordoa, Myriam
Sarriugarte, Garbiñe
Mar, Javier
author Arrospide, Arantzazu
author_facet Arrospide, Arantzazu
Rué, Montserrat
Van Ravesteyn, Nicolien T.
Comas Serrano, Mercè
Soto-Gordoa, Myriam
Sarriugarte, Garbiñe
Mar, Javier
author_role author
author2 Rué, Montserrat
Van Ravesteyn, Nicolien T.
Comas Serrano, Mercè
Soto-Gordoa, Myriam
Sarriugarte, Garbiñe
Mar, Javier
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Mama -- Càncer -- Espanya
Cost-eficàcia
topic Mama -- Càncer -- Espanya
Cost-eficàcia
description BACKGROUND: Breast cancer screening in the Basque Country has shown 20 % reduction of the number of BC deaths and an acceptable overdiagnosis level (4 % of screen detected BC). The aim of this study was to evaluate the breast cancer early detection programme in the Basque Country in terms of retrospective cost-effectiveness and budget impact from 1996 to 2011. METHODS: A discrete event simulation model was built to reproduce the natural history of breast cancer (BC). We estimated for lifetime follow-up the total cost of BC (screening, diagnosis and treatment), as well as quality-adjusted life years (QALY), for women invited to participate in the evaluated programme during the 15-year period in the actual screening scenario and in a hypothetical unscreened scenario. An incremental cost-effectiveness ratio was calculated with the use of aggregated costs. Besides, annual costs were considered for budget impact analysis. Both population level and single-cohort analysis were performed. A probabilistic sensitivity analysis was applied to assess the impact of parameters uncertainty. RESULTS: The actual screening programme involved a cost of 1,127 million euros and provided 6.7 million QALYs over the lifetime of the target population, resulting in a gain of 8,666 QALYs for an additional cost of 36.4 million euros, compared with the unscreened scenario. Thus, the incremental cost-effectiveness ratio was 4,214€/QALY. All the model runs in the probabilistic sensitivity analysis resulted in an incremental cost-effectiveness ratio lower than 10,000€/QALY. The screening programme involved an increase of the annual budget of the Basque Health Service by 5.2 million euros from year 2000 onwards. CONCLUSIONS: The BC screening programme in the Basque Country proved to be cost-effective during the evaluated period and determined an affordable budget impact. These results confirm the epidemiological benefits related to the centralised screening system and support the continuation of the programme.
publishDate 2016
dc.date.none.fl_str_mv 2016
2016
2016
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/26984
http://dx.doi.org/10.1186/s12885-016-2386-y
url http://hdl.handle.net/10230/26984
http://dx.doi.org/10.1186/s12885-016-2386-y
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv BMC Cancer. 2016 Jun 1;16(1):344
dc.rights.none.fl_str_mv https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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