Budget impact analysis of implementing a lung cancer screening in high-risk population in Spain
Objective: To analyze the cost of implementing a population-based lung cancer screening program using low-dose radiation computed tomography (CT) in a high-risk population in Spain. Method: A budget impact analysis (5 years) was performed from the National Health System’ perspective, comparing 16 hy...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
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| Series: | Gaceta Sanitaria |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S021391112500069X |
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| Summary: | Objective: To analyze the cost of implementing a population-based lung cancer screening program using low-dose radiation computed tomography (CT) in a high-risk population in Spain. Method: A budget impact analysis (5 years) was performed from the National Health System’ perspective, comparing 16 hypothetical scenarios with screening, based on different age ranges and screening frequencies (annual/biennial), with the current scenario without a lung cancer screening program. Diagnosis, treatment and follow-up costs were considered, as well as the screening costs in the hypothetical scenarios (measured in Euros 2024). From the resident population (50-80 years), the target population and the CT scanners needed to cover the program's demand were calculated. A one-way deterministic sensitivity analysis was performed. Results: The gross budget impact was estimated at €1708.19 million for the current scenario. Among the hypothetical scenarios, it can range from €3737.17 million (biennial screening, 55-65 years) to €10 009.54 million (annual screening, 50-80 years), resulting in a net budget impact of €2028.98-€8301.35 million. By acquiring 100% of the necessary scanners, the investment reached approximately 22% of the annual program's own costs in the first year. The net impact could be reduced to €1858-€7519 million, for 0% acquisition. Conclusions: Implementing a lung cancer screening program would generate a high cost for the Spanish National Health System, amounting more than one billion Euros compared to the scenario without screening. Resumen: Objetivo: Analizar el coste de un programa de cribado de cáncer de pulmón mediante tomografía computarizada (TC) de baja dosis de radiación en población de alto riesgo en España. Método: Se realizó un análisis de impacto presupuestario (5 años) desde la perspectiva del Sistema Nacional de Salud, comparando 16 escenarios hipotéticos de cribado (diferentes rangos de edad y frecuencias de cribado anual o bienal) con el escenario actual sin cribado. Se consideraron los costes de diagnóstico, tratamiento y seguimiento, así como los costes del cribado en los escenarios hipotéticos (euros de 2024). Se estimaron la población diana y los equipos de TC necesarios para el programa. Se realizó un análisis de sensibilidad. Resultados: El impacto presupuestario bruto se estimó en 1708,19 millones de euros (M€) para el escenario actual. En los escenarios hipotéticos, puede oscilar entre 3737,17 M€ (cribado bienal, 55-65 años) y 10.009,54 M€ (cribado anual, 50-80 años), suponiendo un impacto presupuestario neto de 2028,98-8301,35 M€. Adquiriendo el 100% de los escáneres necesarios, la inversión alcanzaría aproximadamente el 22% de los costes anuales propios del programa (año 1). El impacto neto podría reducirse a 1858-7519 M€ para una adquisición del 0%. Conclusiones: Implantar un programa de cribado de cáncer de pulmón generaría un coste elevado para el Sistema Nacional de Salud español, superior a los 1000 millones de euros respecto al escenario sin cribado. |
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| ISSN: | 0213-9111 |