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Giulia Veronesi
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MA23 - Early Stage Lung Cancer: Present and Future (ID 926)
- Event: WCLC 2018
- Type: Mini Oral Abstract Session
- Track: Treatment of Early Stage/Localized Disease
- Presentations: 1
- Moderators:
- Coordinates: 9/26/2018, 10:30 - 12:00, Room 105
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MA23.12 - Discussant - MA 23.09, MA 23.10, MA 23.11 (ID 14615)
11:45 - 12:00 | Presenting Author(s): Giulia Veronesi
- Abstract
- Presentation
Abstract not provided
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P3.11 - Screening and Early Detection (Not CME Accredited Session) (ID 977)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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P3.11-25 - Analysis Indicates Low Incremental Cost-Effectiveness Ratio for Implementation of Lung Cancer Screening in Italy (ID 12905)
12:00 - 13:30 | Presenting Author(s): Giulia Veronesi
- Abstract
Background
Given the potential of early lung cancer detection to improve survival, accurate assessment of the cost-effectiveness of low-dose computed tomography (LDCT) screening is crucial. We report the results of a cost-effectiveness analysis of screening for Italian persons at high risk of lung cancer from the public payer’s perspective
a9ded1e5ce5d75814730bb4caaf49419 Method
The study built on a mathematical decision model to estimate the cost-effectiveness of annual LDCT screening for 5 years in a high-risk population of smokers (at least 30 pack-years) aged 55-79 years. The stage distribution of patients diagnosed as part of the COSMOS screening study was used for the “screening arm;” the stage distribution of patients in the SEER database was used for the “usual care arm.” Treatment costs were determined using detailed individual-level administrative information from our Institutional database of lung cancer patients. Lung cancer survival in screened patients was adjusted for 2 year-lead time bias. The model estimated expected future life years using survival probabilities according to age, sex, and lung cancer stage (or no lung cancer). Quality-Adjusted Life Years (QALYs) gained and Life Years (LY) gained were estimated.
4c3880bb027f159e801041b1021e88e8 Result
The base-case incremental cost for each QALY gained was 4747,57 Euro. The incremental cost-effectiveness ratio (ICER) for each LY gained was 4069 Euro. An extensive sensitivity analysis showed that model outcomes were particularly sensitive to lung cancer prevalence, the sensitivity and specificity of screening, and the lead-time bias assumed.
8eea62084ca7e541d918e823422bd82e Conclusion
Our analysis indicates that LDCT screening is associated with a low ICER of 4069 Euro, meaning that this is the yearly incremental cost of saving the life of a patient, and is lower than the ICER accepted by the Italian government. The implication is that implementation of screening throughout Italy can be achieved at a relatively low cost, a finding which should be taken into account by health policy decision-maker.
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