Opportunities and challenges for implementation of cost-effective lung cancer screening

Abstract

In this article, we summarize the findings of our recent cost-effectiveness evaluation of lung cancer screening with low-dose computed tomography (LDCT) [1] in which we applied Australian health services costs and populationbased survival data to the outcomes observed in the U.S. National Lung Screening Trial (NLST) [2] and assessed the impact of a range of screening scenarios on incremental cost effectiveness ratios (ICER) [1]. Our base case estimate was A$138,000 (± €87,000) per life-year gained and $233,000 (± €146,000) per quality-adjusted life year (QALY) gained. Compared to an indicative willingnessto-pay threshold of A$30,000-50,000 (± €19,000 - € 31,500) lung screening is not yet likely to be cost-effective in Australia. Variation in base-case parameters resulted in ICER estimations that ranged from A$127,000 to A$509,000 (± €80,000 to €320,000) per QALY gained.