Cost-effectiveness of a population-based AAA screening program for men over 65 years old in Iran

Area of Science:

• Health Economics
• Preventive Medicine
• Vascular Surgery

Background:

• Screening programs aim for early disease detection and improved health outcomes.
• Cost-effectiveness of abdominal aortic aneurysm (AAA) screening is understudied in developing nations.
• This study evaluates the cost-effectiveness of AAA screening in Iranian men aged over 65.

Purpose of the Study:

• To assess the economic viability of a population-based AAA screening program in Iran.
• To compare the costs and benefits of AAA screening versus no screening.
• To inform healthcare policy regarding AAA screening implementation.

Main Methods:

• A Markov cohort model simulated 11 health states over a lifetime horizon.
• Data on disease progression and quality of life were sourced from literature.
• Costs were based on Iranian medical service prices and patient records.
• Analysis considered payer perspective with a 3% discount rate.
• Sensitivity analyses addressed uncertainty in model inputs.

Main Results:

• The AAA screening strategy incurred an incremental cost of $140 with a 0.025 quality-adjusted life-year (QALY) gain.
• The incremental cost-effectiveness ratio (ICER) was $5566 per QALY gained.
• At a willingness-to-pay of 1 GDP per capita, cost-effectiveness probability was ~50%.
• At twice the GDP per capita, cost-effectiveness probability reached ~95%.

Conclusions:

• A one-time AAA screening for men over 65 is not cost-effective at a willingness-to-pay of 1 GDP per capita in Iran.
• The AAA screening program demonstrates cost-effectiveness at a willingness-to-pay of twice the GDP per capita.
• Targeted AAA screening in high-risk populations may be cost-effective even at 1 GDP per capita.