The impact of healthcare costs in the last year of life and in all life years gained on the cost-effectiveness of cancer screening

De Kok, I. M. C. M.; Polder, J. J.; Habbema, J. D. F.; Berkers, L.-M.; Meerding, W. J.; Rebolj, M.; Van Ballegooijen, M.
April 2009
British Journal of Cancer;4/21/2009, Vol. 100 Issue 8, p1240
Academic Journal
It is under debate whether healthcare costs related to death and in life years gained (LysG) due to life saving interventions should be included in economic evaluations. We estimated the impact of including these costs on cost-effectiveness of cancer screening. We obtained health insurance, home care, nursing homes, and mortality data for 2.1 million inhabitants in the Netherlands in 1998–1999. Costs related to death were approximated by the healthcare costs in the last year of life (LastYL), by cause and age of death. Costs in LYsG were estimated by calculating the healthcare costs in any life year. We calculated the change in cost-effectiveness ratios (CERs) if unrelated healthcare costs in the LastYL or in LYsG would be included. Costs in the LastYL were on average 33% higher for persons dying from cancer than from any cause. Including costs in LysG increased the CER by \[euro]4040 in women, and by \[euro]4100 in men. Of these, \[euro]660 in women, and \[euro]890 in men, were costs in the LastYL. Including unrelated healthcare costs in the LastYL or in LYsG will change the comparative cost-effectiveness of healthcare programmes. The CERs of cancer screening programmes will clearly increase, with approximately \[euro]4000. However, because of the favourable CER's, including unrelated healthcare costs will in general have limited policy implications.British Journal of Cancer (2009) 100, 1240–1244. doi:10.1038/sj.bjc.6605018 www.bjcancer.com


Related Articles

  • Cost-effectiveness of family history-based colorectal cancer screening in Australia. Ouakrim, Driss A.; Boussioutas, Alex; Lockett, Trevor; Hopper, John L.; Jenkins, Mark A. // BMC Cancer;2014, Vol. 14 Issue 1, p1 

    Background: With 14.234 diagnoses and over 4047 deaths reported in 2007, colorectal cancer (CRC) is the second most common cancer and second most common cause of cancer-related mortality in Australia. The direct treatment cost has recently been estimated to be around AU$1.2 billion for the year...

  • Analyse coût-efficacité des stratégies de dépistage du cancer du col utérin en Tunisie. Lazaar, H. Ben Gobrane; Aounallah-Skhiri, H.; Oueslati, F.; Frikha, H.; Achour, N.; Hsairi, M. // Eastern Mediterranean Health Journal;jun2010, Vol. 16 Issue 6, p460 

    We aimed to identify the most appropriate screening strategy for cervical cancer (periodicity of 3, 5 or 10 years) for Tunisia, taking into consideration the incidence of the disease, costs of screening and economic implications. We simulated follow-up of a fictitious cohort of 1 million women...

  • Not Just Smoke and Mirrors. Gaerig, Chris // Imaging Economics;Aug2012, Vol. 25 Issue 7, p8 

    The article reports on a study conducted by Milliman Inc. which examines the effectiveness of a low-dose computed tomography (CT) as a screening tool for patients who are high risk of lung cancer in the U.S. Findings reveal that the said approach shows a 20% reduction of mortality. It also...

  • Cancer Screening and Cancer Mortality in Nevis, West Indies. Felix, A. S.; Avery, G.; Mutetwa, B.; Ishmael, R.; Ragin, C.; Taioli, E. // West Indian Medical Journal;Sep2009, Vol. 58 Issue 4, p311 

    Objective: Cancer screening is one approach that can reduce morbidity and mortality through early detection of pre-cancers; however anxiety, fear, and lack of information are important barriers to universal cancer screening in the Caribbean. Nevis is a small island located in the Eastern...

  • Alternative screening methods may reduce mortality in prostate cancer.  // Hem/Onc Today;4/25/2013, Vol. 14 Issue 8, p11 

    The article discusses the results of a study which showed that mortality was reduced by prostate cancer screening methods that increase the threshold for biopsy referral for older men and lessen screening among those with low prostate-specific antigen (PSA).

  • Navigated intervention for CRC screening effective but costly.  // PharmacoEconomics & Outcomes News;Feb2014, Issue 695, p7 

    The article discusses the findings of a study published in the journal "Cancer," which showed the higher cost of tailored navigational intervention (TNI) compared to standard intervention (SI) in increasing the screening rates of colorectal cancer (CRC).

  • Saving time and money on colonoscopies. Gaby, Alan R. // Townsend Letter for Doctors & Patients;Apr2005, Issue 261, p26 

    Provides some insights into the benefits and cost-effectiveness of colonoscopies for the screening of colon cancer in the U.S. Sedation of patients who will undergo colonoscopy; Increase in the number of insurers who agree to pay for routine colonoscopies; Indications of health care costs.

  • Advanced age should not preclude HIV screening.  // PharmacoEconomics & Outcomes News;7/26/2008, Issue 558, p5 

    The article reports on the results of a U.S. study which found that the cost effectiveness of routine HIV screening in persons aged 55-75 years compares well with other accepted interventions. The researchers used a Markov-based model in the study and costs, reported in 2007 values and...

  • Cost‐effectiveness of organized versus opportunistic cervical cytology screening in Hong Kong. Kim, Jane J.; Leung, Gabriel M.; Woo, Pauline P. S.; Goldie, Sue J. // Journal of Public Health;Jun2004, Vol. 26 Issue 2, p130 

    Background To assess the cost‐effectiveness of alternative cervical cancer screening strategies to inform the design and implementation of a government‐sponsored population‐based screening programme in Hong Kong.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics