Document Detail


Modeling cost-effectiveness of cervical cancer screening in hungary.
MedLine Citation:
PMID:  22264970     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVES: Our aim was to compare the cost-effectiveness of two national cervical cancer screening programs aiming to involve those who do not regularly participate in the screening program in Hungary with no screening, using a public health-care payer's perspective and a 20-year time horizon.
METHODS: We built a Markov model based on disease progression. The health-care costs of screening and treatment were received from real-word data. Other input data were obtained from the literature. The cost-effectiveness of the current screening program (a screening test that combines cytology and colposcopy in gynecological outpatient services) and of a planned new screening program (only cytology, and Pap smear is taken locally by public health nurses), both supported with a more active communication campaign, were compared with no screening.
RESULTS: The incremental cost-effectiveness ratio of the intensified current screening practice was $33,100 per quality-adjusted life-year compared with no screening, whereas the incremental cost-effectiveness ratio of the renewed program was $18,990 per quality-adjusted life-year compared with no screening. The most influential parameters in the deterministic analysis were the quality-of-life weights of undetected stage I or IIA cancer. In the probabilistic sensitivity analysis, 99.9% of the simulations were below the incremental cost-effectiveness ratio of $30,000 per quality-adjusted life-year in the case of the renewed strategy.
CONCLUSIONS: Providing services closer to the population is a rational economic option for the reform of the Hungarian cervical cancer screening program. The other policy aspects of this development, human resource need, stakeholders' interests, organizational aspects, and attitude of the target population need to be carefully considered.
Authors:
Zoltán Vokó; László Nagyjánosi; Barnabás Margitai; Rita Kövi; Zoltán Tóth; Dániel László; Zoltán Kaló
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research     Volume:  15     ISSN:  1524-4733     ISO Abbreviation:  Value Health     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883818     Medline TA:  Value Health     Country:  United States    
Other Details:
Languages:  eng     Pagination:  39-45     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Health Policy and Health Economics, Institute of Economics, Faculty of Social Sciences, Eötvös Loránd University, Budapest, Hungary; Syreon Research Institute, Budapest, Hungary.
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