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

• Published in: Lung cancer (Amsterdam, Netherlands) Netherlands), 2018-12, Vol.126, p.119-124
• Main Authors: Hinde, Sebastian, Crilly, Tessa, Balata, Haval, Bartlett, Rachel, Crilly, John, Barber, Phil, Threlfall, Anthony, Tonge, Janet, Booton, Richard, Crosbie, Phil A.
• Format: Article
• Language: English
• Subjects: Cost-effectiveness; Early detection; Economic evaluation; Low-dose CT; Lung cancer; Screening
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/j.lungcan.2018.10.029

•The use of CT to screen for lung cancer remains hotly debated.•We explored the cost-effectiveness of screening in a targeted community setting.•By updating evaluation methodology used in UKLS we ensure consistency of findings.•We find the use of community screening to be cost-effective. 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. 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. 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. 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.