Original Title: Estudio de costes del programa de detección precoz del cáncer de mama de la Comunidad Autónoma del País Vasco. Revisión sistemática de estudios de evaluación económica del cribado de cáncer de mama

Authors' objectives: • Carry out a systematic review of the economic evaluation studies of breast cancer screening programmes. • Evaluate the costs of the early detection programme of the Basque Community not only as a whole, but during its different stages and activities and for its different management and operative units as well. • Obtain economic indicators which will be used for subsequent analyses of the impact of the early detection programme.

Authors' results and conclusions: Of the bibliographical review Five Spanish cost evaluation studies of Breast Cancer Screening Programmes were found. These present detailed information on different methodological aspects and results in several different evidence tables. The effectiveness cost ratios of similar programmes to that of the Basque Country, involving the screening of women aged between 50 and 69, are estimated at approximately 21,585 euros per quality adjusted life years and 19,585 euros per life year gained, much lower than those considered to be acceptable in the public health systems of our environment (25,000-35,000 euros). The results of international cost evaluations that deal specifically with the cost effectiveness of early detection programmes in women younger than 50 years of age or of over 69 years of age, in women both with and without personal or family high-risk histories. Of the cost study of the early detection programme of the Basque Country • In line with the growth in the population volume included in the programme and the technological changes, the total cost of the early detection programme was 3.7 million euros in 2007, 4 million euros in 2008 and 4.5 million euros in 2009. • The cost per woman screened was 39.29 € in 2007, 40.53 € in 2008 and 42.28 € in 2009. However, for each woman invited to take part in the programme, the cost represents around 9 € less than the cost per woman actually screened. • The cost per cancer detected was 10,366 € in 2007, 10,168 € in 2008 and 11,522 € in 2009. CONCLUSIONS AND RECOMMENDATIONS Of the bibliographical review • Extending screening to women of under 50 years of age, but with high-risk personal or family histories and especially carriers of mutations that greatly increase the risk of breast cancer, is a reasonable option in our environment because the different European studies available estimate cost-effectiveness ratios lower than those considered to be acceptable in public health systems. The cost effectiveness of the option to extend screening to women without personal or family histories of high-risk is very low. Of the cost study of the early detection programme of the Basque Country • In general, the costs of the early detection programme show very small variability when the programme is carried out by the Basque Health Service’s own resources(Bizkaia and Araba). However, those activities subcontracted to private sector medical services (Gipuzkoa) have a higher cost level. • The costs of the early detection programme are in line with the costs of other national programmes in which the cost per woman screened amounted to 49 € in 2007.

Authors' methods: • Systematic review of economic evaluation studies on the population screening of breast cancer. • Analysis of direct and indirect costs of the Basque Community programme from the perspective of the health system using the bottom-up procedure based on a record of the resources used for each one of the centres that took part in the programme in 2007, 2008 and 2009 and their conversion into monetary units.

Project Status: Completed

Year Published: 2012

URL for published report: https://www.euskadi.eus/contenidos/informacion/2012_osteba_publicacion/es_def/adjuntos/D-12-03_WEB%20_estudio%20de%20costes%20PDPCM.pdf

English language abstract: An English language summary is available

Publication Type: Other

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: <p>Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government</p>