Unit costs in population-based colorectal cancer screening using CT colonography performed in university hospitals in Th
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Unit costs in population-based colorectal cancer screening using CT colonography performed in university hospitals in The Netherlands M. C. de Haan & M. Thomeer & J. Stoker & E. Dekker & E. J. Kuipers & M. van Ballegooijen
Received: 19 May 2012 / Accepted: 29 September 2012 / Published online: 9 November 2012 # European Society of Radiology 2012
Abstract Objectives Computed tomography (CT) colonography cost assumptions so far ranged from €346 to €594 per procedure, based on clinical CT reimbursement rates. The aim of our study was to estimate the costs in a screening situation. Methods Data were collected within an invitational population-based CRC screening trial (n02,920, age 50– 75 years) with a dedicated CT-screening setting. Unit costs were calculated per action, per invitee and per participant (depending on adherence) and per individual with detected advanced neoplasia. Sensitivity analyses were performed, and alternative scenarios were considered. M. C. de Haan (*) : J. Stoker Department of Radiology, G1-228, Academic Medical Center, PO Box 22700, 1100 DE Amsterdam, The Netherlands e-mail: [email protected] M. Thomeer Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands E. Dekker Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands E. J. Kuipers Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands E. J. Kuipers Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands M. van Ballegooijen Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
Results Of the invitees, 47.2 % were reminded, 38.8 % scheduled for an intake, 37.2 % scheduled for CT colonography, 33.6 % underwent CT colonography and 1.1 % needed a reexamination. Lesions ≥10 mm were detected in 2.9 % of the invitees. Invitation costs were €5.57. Costs per CT colonography (intake to results) were €144.00. Extra costs of communication of positive results were €9.00. Average costs of invitational-based CT colonography screening were €56.97 per invitee, €169.40 per participant and €2,772.51 per individual with detected advanced neoplasia. Conclusions Dutch costs of CT-screening were substantially lower than the cost assumptions that were used in published cost-effectiveness analyses on CT colonography screening. This finding indicates that previous cost-effectiveness analyses should be updated, at least for the Dutch situation. Key Points • CT colonography screening costs have historically been based on (local) clinical reimbursement rates • Estimates ranged from €346–€594, based on abdominal and/or pelvic computed tomography • Average costs per participant within an invitational population-based screening program: €169.40 • Average CT colonography costs per individual with detected advanced neoplasia: €2,772.51 • Previous cost-effectiveness analyses should probably be updated Keywords Unit costs . CT colonography . Virtu
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