Ribeiro Rodrigo Antonini, Caleffi Maira, Polanczyk Carisi Anne
Instituto de Educação e Pesquisa, Hospital Moinhos de Vento, Porto Alegre, Brasil.
Cad Saude Publica. 2013 Nov;29 Suppl 1:S131-45. doi: 10.1590/0102-311x00005213.
The aim of this study was to evaluate the cost-effectiveness of an organized breast cancer mammographic screening program implemented in Porto Alegre (Núcleo Mama Porto Alegre - NMPOA), Rio Grande do Sul State, Brazil. A Markov model was constructed to estimate the incremental cost-effectiveness ratio of NMPOA compared to current BC diagnosis and care in the Brazilian public health system, in a hypothetical cohort of women aged 40-69 years at risk of developing breast cancer. Model parameters were collected from NMPOA and the national literature. In the NMPOA strategy, effectiveness was modeled taking into account the actual observed screening adherence. Effectiveness was measured in quality-adjusted life years (QALYs). Incremental cost-effectiveness ratio in the base case was R$ 13,426 per QALY. This result was not sensitive to variation in the main model parameters in sensitivity analyses. Considering the threshold usually suggested as highly attractive in Brazil, breast cancer screening as performed in NMPOA is cost-effective in cities with high incidence of breast cancer.
本研究的目的是评估在巴西南里奥格兰德州阿雷格里港实施的一项有组织的乳腺癌钼靶筛查项目（阿雷格里港乳腺筛查中心 - NMPOA）的成本效益。构建了一个马尔可夫模型，以估计在一个假设的40 - 69岁有患乳腺癌风险的女性队列中，NMPOA与巴西公共卫生系统当前的乳腺癌诊断和治疗相比的增量成本效益比。模型参数取自NMPOA和国家文献。在NMPOA策略中，在建模有效性时考虑了实际观察到的筛查依从性。有效性以质量调整生命年（QALYs）衡量。基础病例中的增量成本效益比为每QALY 13,426雷亚尔。在敏感性分析中，该结果对主要模型参数的变化不敏感。考虑到巴西通常认为极具吸引力的阈值，NMPOA所开展的乳腺癌筛查在乳腺癌高发城市具有成本效益。
