Favorable incremental cost-effectiveness ratio for lung cancer screening in Italy

Veronesi, Giulia; Navone, N.; Novellis, Pierluigi; Dieci, Elisa; Toschi, Luca; Velutti, Laura; Solinas, Michela; Vanni, Elena; Alloisio, Marco; Ghislandi, Simone

doi:10.1016/j.lungcan.2020.03.015

Cited by 23 publications

(18 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In recent years, a series of CEAs for European countries have been published: in Germany, two studies found an incremental cost-effectiveness ratio (ICER) of €19,302 per life year (LY) gained (€30,241 per QALY) and €16,754-23,847 per LY [172,173]; in the UK, two studies found an ICER lower than £11,000 per QALY [39,174], whereas the most recent study found an ICER between £20,000 and £30,000 per QALY, but under extreme assumptions, such as very small cost advantage in treating Stages I and IV and no increase in average survival between the screening and no-screening scenarios [175]; in Poland, an ICER of €1353 per LY gained was found [176]. For Italy, our simulation-based model populated with real-world cost data from hospital records found an ICER of €3297 per QALY gained and €2944 per LY gained [177]: note that this is the most recent study in this sense, and it included immunotherapy for the treatment of Stages III and IV.…”

Section: Cost-effectiveness Of Mass Ldct Screening For Lung Cancer-a mentioning

confidence: 84%

Recommendations for Implementing Lung Cancer Screening with Low-Dose Computed Tomography in Europe

Veronesi

Baldwin

Henschke

et al. 2020

Cancers

Self Cite

View full text Add to dashboard Cite

Lung cancer screening (LCS) with low-dose computed tomography (LDCT) was demonstrated in the National Lung Screening Trial (NLST) to reduce mortality from the disease. European mortality data has recently become available from the Nelson randomised controlled trial, which confirmed lung cancer mortality reductions by 26% in men and 39–61% in women. Recent studies in Europe and the USA also showed positive results in screening workers exposed to asbestos. All European experts attending the “Initiative for European Lung Screening (IELS)”—a large international group of physicians and other experts concerned with lung cancer—agreed that LDCT-LCS should be implemented in Europe. However, the economic impact of LDCT-LCS and guidelines for its effective and safe implementation still need to be formulated. To this purpose, the IELS was asked to prepare recommendations to implement LCS and examine outstanding issues. A subgroup carried out a comprehensive literature review on LDCT-LCS and presented findings at a meeting held in Milan in November 2018. The present recommendations reflect that consensus was reached.

show abstract

Section: Cost-effectiveness Of Mass Ldct Screening For Lung Cancer-a mentioning

confidence: 84%

Recommendations for Implementing Lung Cancer Screening with Low-Dose Computed Tomography in Europe

Veronesi

Baldwin

Henschke

et al. 2020

Cancers

Self Cite

View full text Add to dashboard Cite

show abstract

“…For Italy, our group found an ICER of €3,297 per QALY gained and €2,944 per life-year gained (50). This is the most recent study covering this issue and included the new treatment options of advanced stage lung cancer.…”

Section: Cea In the European And International Settingmentioning

confidence: 90%

Lung cancer screening: who pays? Who receives? The European perspectives

Novellis¹,

Cominesi²,

Rossetti³

et al. 2021

Transl Lung Cancer Res

Self Cite

View full text Add to dashboard Cite

Lung cancer is the leading cause of cancer-related death worldwide, and its early detection is critical to achieving a curative treatment and to reducing mortality. Low-dose computed tomography (LDCT) is a highly sensitive technique for detecting noninvasive small lung tumors in high-risk populations.We here analyze the current status of lung cancer screening (LCS) from a European point of view. With economic burden of health care in most European countries resting on the state, it is important to reduce costs of screening and improve its effectiveness. Current cost-effectiveness analyses on LCS have indicated a favorable economic profile. The most recently published analysis reported an incremental cost-effectiveness ratio (ICER) of €3,297 per 1 life-year gained adjusted for the quality of life (QALY) and €2,944 per life-year gained, demonstrating a 90% probability of ICER being below €15,000 and a 98.1% probability of being below €25,000. Different risk models have been used to identify the target population; among these, the PLCOM2012 in particular allows for the selection of the population to be screened with high sensitivity.Risk models should also be employed to define screening intervals, which can reduce the general number of LDCT scans after the baseline round. Future perspectives of screening in a European scenario are related to the will of the policy makers to implement policy on a large scale and to improve the effectiveness of a broad screening of smoking-related disease, including cardiovascular prevention, by measuring coronary calcium score on LDCT. The employment of artificial intelligence (AI) in imaging interpretation, the use of liquid biopsies for the characterization of CT-detected undetermined nodules, and less invasive, personalized surgical treatments, will improve the effectiveness of LCS.

show abstract

“…In total, 16 (48%) studies present ACERs rather than ICERs [25,30,[39][40][41][42][43][44][45][46][47][48][49][50][51][52]]. An additional 6 (18%) studies estimate ICERs of annual screening without assessment against biennial comparators [28,[32][33][34][35][36].…”

Section: Comparisons and Cost-effectiveness Ratiosmentioning

confidence: 99%

Cost-Effectiveness Analyses of Lung Cancer Screening Using Low-Dose Computed Tomography: A Systematic Review Assessing Strategy Comparison and Risk Stratification

Fabbro

Hahn

Novaes

et al. 2022

PharmacoEconomics Open

View full text Add to dashboard Cite

Objectives Our first study objective was to assess the range of lung cancer screening intervals compared within cost-effectiveness analyses (CEAs) of low-dose computed tomography (LDCT) and to examine the implications for the strategies identified as optimally cost effective; the second objective was to examine if and how risk subgroup-specific policies were considered. Methods PubMed, Embase and Web of Science were searched for model-based CEAs of LDCT lung screening. The retrieved studies were assessed to examine if the analyses considered sufficient strategy variation to permit incremental estimation of cost effectiveness. Regarding risk selection, we examined if analyses considered alternative risk strata in separate analyses or as alternative risk-based eligibility criteria for screening. ResultsThe search identified 33 eligible CEAs, 23 of which only considered one screening frequency. Of the 10 analyses considering multiple screening intervals, only 4 included intervals longer than 2 years. Within the 10 studies considering multiple intervals, the optimal policy choice would differ in 5 if biennial intervals or longer had not been considered. Nineteen studies conducted risk subgroup analyses, 12 of which assumed that subgroup-specific policies were possible and 7 of which assumed that a common screening policy applies to all those screened. Conclusions The comparison of multiple strategies is recognised as good practice in CEA when seeking optimal policies. Studies that do include multiple intervals indicate that screening intervals longer than 1 year can be relevant. The omission of intervals of 2 years or longer from CEAs of LDCT screening could lead to the adoption of sub-optimal policies. There also is scope for greater consideration of risk-stratified policies which tailor screening intensity to estimated disease risk. Policy makers should take care when interpreting current evidence before implementing lung screening.

show abstract

Favorable incremental cost-effectiveness ratio for lung cancer screening in Italy

Cited by 23 publications

References 29 publications

Recommendations for Implementing Lung Cancer Screening with Low-Dose Computed Tomography in Europe

Recommendations for Implementing Lung Cancer Screening with Low-Dose Computed Tomography in Europe

Lung cancer screening: who pays? Who receives? The European perspectives

Cost-Effectiveness Analyses of Lung Cancer Screening Using Low-Dose Computed Tomography: A Systematic Review Assessing Strategy Comparison and Risk Stratification

Contact Info

Product

Resources

About