Protocol for the economic evaluation of LCS in Ireland: modelling costs, eligibility, and outcomes

Lung cancer (LC) is the leading cause of cancer death in Ireland, yet no national screening programme exists. While low-dose computed tomography (LDCT) screening reduces lung cancer mortality by approximately 20% in high-risk populations, its cost-effectiveness in Ireland remains uncertain. Evidence on the economic burden of lung cancer care and the feasibility of screening is needed to support policy decisions.

This research programme will evaluate the economic impact of lung cancer care in Ireland and assess the cost-effectiveness of LDCT screening. By integrating screening eligibility modelling, stage-specific cost analysis, and economic evaluation, the study aims to generate evidence to support resource allocation and policy development.

The programme consists of three interlinked work packages. First, screening eligibility will be estimated using a dynamic Markov model that integrates demographic data from the Central Statistics Office (CSO), population projections, and smoking history data from Eurobarometer. Second, a stage-specific cost analysis will be conducted using a discrete event simulation (DES) model informed by data from the National Cancer Registry Ireland (NCRI), the Healthcare Pricing Office (HPO), and other healthcare reimbursement sources. Third, a cost-effectiveness analysis will adapt a UK-based LC natural history model (updated ENaBL model 2022) to evaluate alternative screening strategies, incorporating Irish-specific costs, clinical outcomes, and quality-adjusted life-years (QALYs).

This programme will generate evidence to inform the design of a cost-effective LCS programme in Ireland. Findings will guide healthcare planning, optimise screening strategies, and support sustainable policy decisions.