基于对虚假阳性结果的真实数据进行的台湾乳房扫描查计划的成本效益评估
Chia-Ni Lin1, Kuo-Ting Lee2, Jung-Der Wang3
1Department of Public Health, National Cheng Kung University, Tainan, Taiwan.
概括
台湾的乳房扫描查具有成本效益,其增量成本效益比率 (ICER) 远低于支付意愿的门. 这项分析考虑了经质量调整的预期寿命和乳腺癌查的错误阳性成本.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生 公共卫生
- 在瘤学瘤学.
背景情况:
- 乳房扫描查对于早期发现乳腺癌至关重要.
- 评估查计划需要了解质量调整的预期寿命 (QALE) 和相关成本,包括错误阳性 (FP).
- 台湾国家医疗保险数据为成本效益分析提供了基础.
研究的目的:
- 估计QALE的特定阶段损失和权重阶段分布,考虑到台湾乳房扫描查FP成本.
- 通过增量成本效益比率 (ICER) 评估乳房扫描查的成本效益.
主要方法:
- 通过将生存概率和实用 (EQ-5D-3L) 与年龄匹配的参考人群进行比较,计算了QALE损失.
- 定量化FP成本,包括国家医疗保险在没有BC.的阳性查后一年内为服务的报销.
- 通过比较接受查和未接受查的妇女之间的QALE损失的阶段比例加权金额 (2004-2013) 来确定每年的ICER.
主要成果:
- 具体阶段的QALE丧失从0.3年 (I阶段) 到22.9年 (IV阶段) 不同.
- 确定了355,489 (11.1%) 的FP病例,平均成本为2,126美元,每次检测到BC.
- 2010年后乳房扫描查的ICER推广是每QALY855美元,约为台湾WTP的三分之一.
结论:
- 台湾的乳房扫描显示出有希望的成本效益,超过53万名妇女的覆盖率为22%.
- ICER认为,与支付意愿门相比,该计划在经济上是有利的.
- 建议进行进一步的研究,从社会角度评估生产力损失的节约.
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