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The European Journal of Health Economics
Published in: The European Journal of Health Economics 5/2018

01-06-2018 | Original Paper

Cost analysis of colorectal cancer screening with CT colonography in Italy

Authors: Paola Mantellini, Giuseppe Lippi, Lapo Sali, Grazia Grazzini, Silvia Delsanto, Beatrice Mallardi, Massimo Falchini, Guido Castiglione, Francesca Maria Carozzi, Mario Mascalchi, Stefano Milani, Leonardo Ventura, Marco Zappa

Published in: The European Journal of Health Economics | Issue 5/2018

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Abstract

Objective

Unit costs of screening CT colonography (CTC) can be useful for cost-effectiveness analyses and for health care decision-making. We evaluated the unit costs of CTC as a primary screening test for colorectal cancer in the setting of a randomized trial in Italy.

Methods

Data were collected within the randomized SAVE trial. Subjects were invited to screening CTC by mail and requested to have a pre-examination consultation. CTCs were performed with 64- and 128-slice CT scanners after reduced or full bowel preparation. Activity-based costing was used to determine unit costs per-process, per-participant to screening CTC, and per-subject with advanced neoplasia.

Results

Among 5242 subjects invited to undergo screening CTC, 1312 had pre-examination consultation and 1286 ultimately underwent CTC. Among 129 subjects with a positive CTC, 126 underwent assessment colonoscopy and 67 were ultimately diagnosed with advanced neoplasia (i.e., cancer or advanced adenoma). Cost per-participant of the entire screening CTC pathway was €196.80. Average cost per-participant for the screening invitation process was €17.04 and €9.45 for the pre-examination consultation process. Average cost per-participant of the CTC execution and reading process was €146.08 and of the diagnostic assessment colonoscopy process was €24.23. Average cost per-subject with advanced neoplasia was €3777.30.

Conclusions

Cost of screening CTC was €196.80 per-participant. Our data suggest that the more relevant cost of screening CTC, amenable of intervention, is related to CTC execution and reading process.
Appendix
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Metadata
Title
Cost analysis of colorectal cancer screening with CT colonography in Italy
Authors
Paola Mantellini
Giuseppe Lippi
Lapo Sali
Grazia Grazzini
Silvia Delsanto
Beatrice Mallardi
Massimo Falchini
Guido Castiglione
Francesca Maria Carozzi
Mario Mascalchi
Stefano Milani
Leonardo Ventura
Marco Zappa
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue 5/2018
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-017-0917-3

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