Cost-Effectiveness of Tomosynthesis in Annual Screening Mammography.
AJR Am J Roentgenol
; 207(5): 1152-1155, 2016 Nov.
Article
en En
| MEDLINE
| ID: mdl-27547861
ABSTRACT
OBJECTIVE:
The purpose of this study was to evaluate the cost-effectiveness of the addition of annual screening tomosynthesis to 2D digital mammography alone for women beginning at 40 years old and to determine differences for age decade subgroups. MATERIALS ANDMETHODS:
Decision-tree analysis comparing annual tomosynthesis versus 2D mammography alone from a federal payer perspective and lifetime horizon was created from published multiinstitutional data, published institutional data, literature values, and Medicare reimbursement rates. Cost-effectiveness was calculated through incremental cost-effectiveness ratios and net monetary benefit calculations. Sensitivity analyses were performed to determine the implication of different variables including changes in recall rate and disutility for false-positives.RESULTS:
Base-case analysis showed an incremental cost per quality-adjusted life year gained for tomosynthesis over 2D alone for all ages (≥ 40 years old) of $20,230, 40- to 49-year-old subgroup of $20,976, 50- to 59-year-old subgroup of $49,725, 60- to 69-year-old subgroup of $44,641, and ≥ 70-year-old subgroup of $82,500. Net monetary benefit per decade in the 40- to 49-year-old subgroup was $1,598, 50- to 59-year-old subgroup of $546, 60- to 69-year-old subgroup of $535, and ≥ 70-year-old subgroup of $501. Tomosynthesis was the better strategy in 63.2% of the iterations according to probabilistic sensitivity analysis.CONCLUSION:
Addition of annual screening tomosynthesis to 2D mammography beginning at the age of 40 years was cost-effective compared with 2D mammography alone in our analysis. Three times greater net monetary benefits were found in women 40-49 years old compared with those 50-59 years old.Palabras clave
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias de la Mama
/
Mamografía
Tipo de estudio:
Diagnostic_studies
/
Health_economic_evaluation
/
Prognostic_studies
/
Screening_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
AJR Am J Roentgenol
Año:
2016
Tipo del documento:
Article