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Cost-Effectiveness Analysis of a Screening Program for Breast Cancer in Vietnam

Citation

Nguyen, Lan Hoang; Laohasiriwong, Wongsa; Stewart, John F.; Wright, Pamela; Nguyen, Yen Thi Bach; & Coyte, Peter C. (2013). Cost-Effectiveness Analysis of a Screening Program for Breast Cancer in Vietnam. Value in Health Regional Issues, 2(1), 21-28.

Abstract

Objective: This study aimed to evaluate the cost-effectiveness of a screening program for breast cancer from the health care payers’ perspective.
Methods: A Markov model was used to compare costs and effects of an annual screening program using clinical breast examination (CBE) with the absence of screening on a cohort of 4,103,285 asymptomatic women aged 40 years. The model was analyzed over the cohort’s lifetime under the assumption that women participated in the screening program annually for 15 years. The model integrated both epidemiological and cost data for breast cancer from prior Vietnamese studies. Costs were measured in 2008 US dollars. Costs and effects were discounted annually at 3%. The incremental cost-effectiveness ratio (ICER) was defined as the difference in cost per life-years saved (LYS). One-way and probabilistic sensitivity analyses were implemented to assess the uncertainty of inputs.
Results: The ICER for the breast cancer screening program with CBE was US $994.96 per LYS compared with the absence of screening. Earlier initiation of the program at age 35 years increased the ICER to US $1196.68 per LYS, while extending the duration of time screened to age 60 years decreased the ICER. Changing the participation rate to 70%, reducing the specificity of CBE testing, and increasing the cost of the screening program by 30% raised ICER estimates to US $1419.32, US $1124.15, and US $1292.03 per LYS, respectively.
Conclusion: Breast cancer screening with CBE for women aged 40 to 55 years is considered very cost-effective in Vietnam according to the World Health Organization criteria.

URL

http://dx.doi.org/10.1016/j.vhri.2013.02.004

Reference Type

Journal Article

Year Published

2013

Journal Title

Value in Health Regional Issues

Author(s)

Nguyen, Lan Hoang
Laohasiriwong, Wongsa
Stewart, John F.
Wright, Pamela
Nguyen, Yen Thi Bach
Coyte, Peter C.