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伊朗女性三轮乳腺钼靶乳腺癌筛查的成本效益分析

Cost-Effectiveness of Three Rounds of Mammography Breast Cancer Screening in Iranian Women.

作者信息

Haghighat Shahpar, Akbari Mohammad Esmaeil, Yavari Parvin, Javanbakht Mehdi, Ghaffari Shahram

机构信息

Breast Cancer Research Center (BCRC), ACECR, Tehran, IR Iran; Epidemiology Department, School of Public Health, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, IR Iran.

Cancer Research Center (CRC), Shahid Beheshti University of Medical Sciences (SBMU), Tehran, IR Iran.

出版信息

Iran J Cancer Prev. 2016 Feb 23;9(1):e5443. doi: 10.17795/ijcp-5443. eCollection 2016 Feb.

DOI:10.17795/ijcp-5443
PMID:27366315
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4922208/
Abstract

BACKGROUND

Breast cancer is the most common cancer in Iranian women as is worldwide. Mammography screening has been introduced as a beneficial method for reducing mortality and morbidity of this disease.

OBJECTIVES

We developed an analytical model to assess the cost effectiveness of an organized mammography screening program in Iran for early detection of the breast cancer.

PATIENTS AND METHODS

This study is an economic evaluation of mammography screening program among Iranian woman aged 40 - 70 years. A decision tree and Markov model were applied to estimate total quality adjusted life years (QALY) and lifetime costs.

RESULTS

The results revealed that the incremental cost effectiveness ratio (ICER) of mammography screening in Iranian women in the first round was Int. $ 37,350 per QALY gained. The model showed that the ICER in the second and third rounds of screening program were Int. $ 141,641 and Int. $ 389,148 respectively.

CONCLUSIONS

Study results identified that mammography screening program was cost-effective in 53% of the cases, but incremental cost per QALY in the second and third rounds of screening are much higher than the accepted payment threshold of Iranian health system. Thus, evaluation of other screening strategies would be useful to identify more cost-effective program. Future studies with new national data can improve the accuracy of our finding and provide better information for health policy makers for decision making.

摘要

背景

乳腺癌是伊朗女性中最常见的癌症,在全球范围内亦是如此。乳腺钼靶筛查已被视为一种降低该疾病死亡率和发病率的有益方法。

目的

我们开发了一种分析模型,以评估伊朗有组织的乳腺钼靶筛查计划用于早期发现乳腺癌的成本效益。

患者与方法

本研究是对年龄在40 - 70岁的伊朗女性乳腺钼靶筛查计划的经济评估。应用决策树和马尔可夫模型来估计总质量调整生命年(QALY)和终生成本。

结果

结果显示,第一轮伊朗女性乳腺钼靶筛查的增量成本效益比(ICER)为每获得一个QALY国际美元37,350。该模型表明,第二轮和第三轮筛查计划的ICER分别为国际美元141,641和国际美元389,148。

结论

研究结果表明,乳腺钼靶筛查计划在53%的情况下具有成本效益,但第二轮和第三轮筛查中每QALY的增量成本远高于伊朗卫生系统认可的支付阈值。因此,评估其他筛查策略将有助于确定更具成本效益的计划。利用新的国家数据进行的未来研究可以提高我们研究结果的准确性,并为卫生政策制定者提供更好的决策信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce10/4922208/c74f5efa861c/ijcp-09-01-5443-i003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce10/4922208/cfa99bfd3c3c/ijcp-09-01-5443-i001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce10/4922208/343610d2881b/ijcp-09-01-5443-i002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce10/4922208/c74f5efa861c/ijcp-09-01-5443-i003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce10/4922208/cfa99bfd3c3c/ijcp-09-01-5443-i001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce10/4922208/343610d2881b/ijcp-09-01-5443-i002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce10/4922208/c74f5efa861c/ijcp-09-01-5443-i003.jpg

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