The cost-effectiveness of the Manchester 'lung health checks', a community-based lung cancer low-dose CT screening pilot

Lung Cancer. 2018 Dec:126:119-124. doi: 10.1016/j.lungcan.2018.10.029. Epub 2018 Nov 2.

Abstract

Background: Previous evaluations of low-dose CT (LDCT) lung cancer screening programmes have taken very different approaches in the design of the informative trials and the methods applied to determine cost-effectiveness. Therefore, it has not been possible to determine if differences in cost-effectiveness are due to different screening approaches or the evaluation methodology. This study reports the findings of an evaluation of the first round of a community-based, LDCT screening pilot Manchester, applying previously published methodology to ensure consistency.

Methods: Using the economic evaluation method reported in the UKLS trial, applying Manchester specific evidence where possible, we estimate the cost-effectiveness of LDCT for lung cancer. Estimates of the total costs and quality adjusted life years (QALYs) were calculated.

Results: The Manchester programme cost £663,076, diagnosed 42 patients with lung cancer resulting in a gain in population health of 88.13 discounted life years, equivalent to 65.85 QALYs. This implied an incremental cost-effectiveness ratio of £10,069/QALY.

Conclusions: We found the Manchester programme to be a cost-effective use of limited NHS resources. The findings suggest that further research is now needed not as to whether LDCT screening is cost-effective but under what conditions can it improve patient health by the most while remaining cost-effective.

Keywords: Cost-effectiveness; Early detection; Economic evaluation; Low-dose CT; Lung cancer; Screening.

MeSH terms

  • Aged
  • Community Health Services / economics*
  • Community Health Services / methods
  • Cost-Benefit Analysis*
  • Early Detection of Cancer / economics*
  • Early Detection of Cancer / methods
  • England
  • Female
  • Humans
  • Lung Neoplasms / diagnosis*
  • Male
  • Mass Screening / economics*
  • Mass Screening / methods
  • Middle Aged
  • Pilot Projects
  • Quality-Adjusted Life Years
  • Survival Analysis
  • Tomography, X-Ray Computed / methods