Cost-effectiveness of screening mammography in a low income country: a Markov simulation analysis

Abstract Background Breast cancer is the most common cancer diagnosed in women. Screening mammography is the only imaging screening study for breast cancer with a proven. mortality benefit. This study aims to analyze the cost-effectiveness of screening mammography in Ethiopia. Methods Multistate Mar...

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Autor principal:	Segni Kejela
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Markov multistate analysis Low income countries Screening mammography Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/325063d6845e424f87e5580e7b3ccf47
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spelling	oai:doaj.org-article:325063d6845e424f87e5580e7b3ccf472021-11-08T11:05:02ZCost-effectiveness of screening mammography in a low income country: a Markov simulation analysis10.1186/s12880-021-00696-z1471-2342https://doaj.org/article/325063d6845e424f87e5580e7b3ccf472021-11-01T00:00:00Zhttps://doi.org/10.1186/s12880-021-00696-zhttps://doaj.org/toc/1471-2342Abstract Background Breast cancer is the most common cancer diagnosed in women. Screening mammography is the only imaging screening study for breast cancer with a proven. mortality benefit. This study aims to analyze the cost-effectiveness of screening mammography in Ethiopia. Methods Multistate Markov model was used for computer simulation to estimate cost and health benefits of screening mammography interventions for age-group of 40–49 years and 50–59 years. The cost-effectiveness analysis was made for 4 policies based on where the screening mammography procedures were conducted: government institution only, the private institution only, 50% ratio for each, and 10% private institution policy. Outputs were expressed in total cost, life-years gained (LYG) incremental cost-effectiveness ratio (ICER), and incremental net monetary benefit (INMB). Results All 4 policies of annual screening mammography failed to achieve acceptable ICER and lead to a net loss in INMB. The lowest ICER value was for government institution-only policy with 3510.3 USD/LYG and 3224.9 USD/LYG both above the cost-effectiveness threshold of 2808.5 USD. The cost per single death averted for each group was 110,206.7 USD and 77,088.2 USD for age-group 40–49 years and 50–59 years respectively. Conclusion Screening mammography could not be shown to be cost-effective in Ethiopia with the current low cost-effectiveness threshold. Alternative screening approach like annual clinical breast examination may need to be investigated.Segni KejelaBMCarticleMarkov multistate analysisLow income countriesScreening mammographyMedical technologyR855-855.5ENBMC Medical Imaging, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Markov multistate analysis Low income countries Screening mammography Medical technology R855-855.5
spellingShingle	Markov multistate analysis Low income countries Screening mammography Medical technology R855-855.5 Segni Kejela Cost-effectiveness of screening mammography in a low income country: a Markov simulation analysis
description	Abstract Background Breast cancer is the most common cancer diagnosed in women. Screening mammography is the only imaging screening study for breast cancer with a proven. mortality benefit. This study aims to analyze the cost-effectiveness of screening mammography in Ethiopia. Methods Multistate Markov model was used for computer simulation to estimate cost and health benefits of screening mammography interventions for age-group of 40–49 years and 50–59 years. The cost-effectiveness analysis was made for 4 policies based on where the screening mammography procedures were conducted: government institution only, the private institution only, 50% ratio for each, and 10% private institution policy. Outputs were expressed in total cost, life-years gained (LYG) incremental cost-effectiveness ratio (ICER), and incremental net monetary benefit (INMB). Results All 4 policies of annual screening mammography failed to achieve acceptable ICER and lead to a net loss in INMB. The lowest ICER value was for government institution-only policy with 3510.3 USD/LYG and 3224.9 USD/LYG both above the cost-effectiveness threshold of 2808.5 USD. The cost per single death averted for each group was 110,206.7 USD and 77,088.2 USD for age-group 40–49 years and 50–59 years respectively. Conclusion Screening mammography could not be shown to be cost-effective in Ethiopia with the current low cost-effectiveness threshold. Alternative screening approach like annual clinical breast examination may need to be investigated.
format	article
author	Segni Kejela
author_facet	Segni Kejela
author_sort	Segni Kejela
title	Cost-effectiveness of screening mammography in a low income country: a Markov simulation analysis
title_short	Cost-effectiveness of screening mammography in a low income country: a Markov simulation analysis
title_full	Cost-effectiveness of screening mammography in a low income country: a Markov simulation analysis
title_fullStr	Cost-effectiveness of screening mammography in a low income country: a Markov simulation analysis
title_full_unstemmed	Cost-effectiveness of screening mammography in a low income country: a Markov simulation analysis
title_sort	cost-effectiveness of screening mammography in a low income country: a markov simulation analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/325063d6845e424f87e5580e7b3ccf47
work_keys_str_mv	AT segnikejela costeffectivenessofscreeningmammographyinalowincomecountryamarkovsimulationanalysis
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Cost-effectiveness of screening mammography in a low income country: a Markov simulation analysis

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