Cost-effectiveness of Low-Dose Computed Tomography With a Plasma-Based Biomarker for Lung Cancer Screening in China

• DOI: 10.1001/jamanetworkopen.2022.13634
• Publication Date: 2022-05-24T15:22:34Z
• Authors: Zixuan Zhao; Youqing Wang; Weijia Wu; Yi Yang; Lingbin Du; Hengjin Dong
• Keywords: Incremental cost-effectiveness ratio

<h3>Importance</h3> China, which has one-third of the worldwide smoking population, a substantial cancer burden, with lung being leading cause cancer-related death. The effectiveness screening for mortality reduction been confirmed, but cost-effectiveness diverse modalities remains unclear. <h3>Objective</h3> To compare low-dose computed tomography (LDCT) biomarker (micro-RNA signature classifier [MSC]) that LDCT alone by interval and cumulative exposure. <h3>Design, Setting, Participants</h3> In this economic evaluation, comparative analysis used Markov state transition models simulated 1947 to 1971 China birth cohort. Simulated individuals in 8 cohorts 10 000 entered study between ages 50 74 years were followed up until death or age 79 years, corresponding period from January 1, 2021, December 31, 2050. model was run cycle length 1 year. All probabilities validated, health utility values extracted published literature. Cost parameters derived databases local medical insurance bureaus. <h3>Main Outcomes Measures</h3> Primary outcomes included life-years, quality-adjusted life-years (QALYs), incremental ratios (ICERs) future costs discounted 5%. Screening strategies mean ICER less than Chinese yuan (CNY) 212 676 per QALY gained deemed be cost-effective. 7 alternative starting minimum exposure 20 vs 30 pack-years, annual time estimated, including 2021 guideline-recommended strategy (LDCT, annual, pack-years) 2018 pack-years). <h3>Results</h3> population 80 individuals, conjunctive MSC estimated obtain an CNY −793 995.17 254 417.46 (minimum exposure, 20-30 compared alone. China's not cost-effective strategy, higher fewer QALYs gained; loss ranged 0.02 0.15 person increase cost 945.89 5131.29 person. beginning at 70 pack-year history most gained. Lowering pack-years maintaining associated greater savings regardless tool. <h3>Conclusions Relevance</h3> This evaluation found recommendation more recommendation. Moreover, improved when LDCT. These findings may useful modification guidelines screening.