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Supplementary materials: Cost–effectiveness of lung cancer screening with volume computed tomography in Portugal

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posted on 2024-09-27, 11:30 authored by Hilde ten Berge, Katerina Togka, Xuanqi Pan, Marina Borges, Fernando Palma Martelo, Fernando Guedes, Daniel Cabral, Encarnacao Teixeira, Gabriela Fernandes, Lurdes Ferreira, Sara Figueiredo, Rita Sousa, Lourdes Barradas, Fernanda Estevinho, Antonio Araujo, Venceslau Hespanhol, Rui Medeiros

These are peer-reviewed supplementary materials for the article 'Cost–effectiveness of lung cancer screening with volume computed tomography in Portugal' published in the Journal of Comparative Effectiveness Research.

  • Supplementary table 1: Parametric distributions and the corresponding parameters used to extrapolate survival curves
  • Supplementary table 2: Unit costs and utilization for recruitment costs.
  • Supplementary table 3: Diagnostic costs based on the unit costs from the NHS tariffs and utilization values from the NELSON study
  • Supplementary table 4: After care costs for lung cancer patients.
  • Supplementary table 5: End-of-life costs per lung cancer patient per cycle.
  • Supplementary table 6: Parameters used for scenario analyses.
  • References

Aim: Lung cancer is the most common cause of cancer death in Portugal. The Dutch–Belgian lung cancer screening (LCS) study (NELSON), the biggest European LCS study, showed a lung cancer mortality reduction in a high-risk population when being screened. In this study, the cost–effectiveness of LCS, based on the NELSON study protocol and outcomes, was evaluated compared with no screening in Portugal. Methods: The present study modified an established decision tree by incorporating a state-transition Markov model to evaluate the health-related advantages and economic implications of low-dose computed tomography (LDCT) LCS from the healthcare standpoint in Portugal. The analysis compared screening versus no screening for a high-risk population aged 50–75 with a smoking history. Various metrics, including clinical outcomes, costs, quality-adjusted life years (QALYs), life-years (LYs) and the incremental cost–effectiveness ratio (ICER), were calculated to measure the impact of LDCT LCS. Furthermore, scenario and sensitivity analyses were executed to assess the robustness of the obtained results. Results: Annual LCS with volume based LDCT resulted in €558 million additional costs and 86,678 additional QALYs resulting in an ICER of €6440 per QALY for one screening group and a lifetime horizon. In total, 13,217 premature lung cancer deaths could be averted, leading to 1.41 additional QALYs gained per individual diagnosed with lung cancer. Results are robust based on the sensitivity analyses. Conclusion: This study showed that annual LDCT LCS for a high-risk population could be cost-effective in Portugal based on a willingness to pay a threshold of one-time the GDP (€19,290 per QALY gained).

Funding

This work was funded by AstraZeneca PLC.

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