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- Title
Cost analysis of colorectal cancer screening with CT colonography in Italy.
- Authors
Mantellini, Paola; Lippi, Giuseppe; Sali, Lapo; Grazzini, Grazia; Delsanto, Silvia; Mallardi, Beatrice; Falchini, Massimo; Castiglione, Guido; Carozzi, Francesca Maria; Mascalchi, Mario; Milani, Stefano; Ventura, Leonardo; Zappa, Marco
- Abstract
<bold>Objective: </bold>Unit costs of screening CT colonography (CTC) can be useful for cost-effectiveness analyses and for health care decision-making. We evaluated the unit costs of CTC as a primary screening test for colorectal cancer in the setting of a randomized trial in Italy.<bold>Methods: </bold>Data were collected within the randomized SAVE trial. Subjects were invited to screening CTC by mail and requested to have a pre-examination consultation. CTCs were performed with 64- and 128-slice CT scanners after reduced or full bowel preparation. Activity-based costing was used to determine unit costs per-process, per-participant to screening CTC, and per-subject with advanced neoplasia.<bold>Results: </bold>Among 5242 subjects invited to undergo screening CTC, 1312 had pre-examination consultation and 1286 ultimately underwent CTC. Among 129 subjects with a positive CTC, 126 underwent assessment colonoscopy and 67 were ultimately diagnosed with advanced neoplasia (i.e., cancer or advanced adenoma). Cost per-participant of the entire screening CTC pathway was €196.80. Average cost per-participant for the screening invitation process was €17.04 and €9.45 for the pre-examination consultation process. Average cost per-participant of the CTC execution and reading process was €146.08 and of the diagnostic assessment colonoscopy process was €24.23. Average cost per-subject with advanced neoplasia was €3777.30.<bold>Conclusions: </bold>Cost of screening CTC was €196.80 per-participant. Our data suggest that the more relevant cost of screening CTC, amenable of intervention, is related to CTC execution and reading process.
- Subjects
ITALY; COST analysis; COLON cancer treatment; COMPUTED tomography; COLONOSCOPY; MEDICAL screening; EARLY detection of cancer; CLINICAL trials; COLON tumors; RECTUM tumors; RESEARCH funding; STATISTICAL sampling; RANDOMIZED controlled trials; VIRTUAL colonoscopy; ECONOMICS
- Publication
European Journal of Health Economics, 2018, Vol 19, Issue 5, p735
- ISSN
1618-7598
- Publication type
journal article
- DOI
10.1007/s10198-017-0917-3