A simulation approach to cost-effectiveness and cost-benefit calculations of screening for the early detection of disease

• Published in: European journal of operational research 1987, Vol.29 (2), p.159-166
• Main Authors: Habbema, J.D.F., Lubbe, J.Th.N., van Oortmarssen, G.J., van der Maas, P.J.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; cancer; clinical medicine; Computer simulation; Cost analysis; Cost benefit analysis; diagnosis; diagnostics; diseases; Effectiveness; General aspects; Health care industry; health services; Medical sciences; Medical screening; medicine; MISCAN; Monte Carlo simulation; Operations research; optimization; Public health. Hygiene; Public health. Hygiene-occupational medicine; simulation; Software; Statistical analysis
• ISSN: 0377-2217; 1872-6860
• DOI: 10.1016/0377-2217(87)90105-6

The computer simulation program Miscan, developed for analysis, prediction and optimization of screening for early detection of disease, has been extended to enable full cost-effectiveness and cost-benefit calculations. The user specifies which of the available cost- and effectiveness-items are to be used and can choose the valuation per unit for each item. The program computes the volume of each item for scenarios with and without screening, and calculates the costs and effectiveness of the simulated screening policy. The program allows for discounting and present value computations, for scale effects, and for quality adjustment of life years for age and disease stage. The use of the program is illustrated with a model of cervical cancer screening that was based on data from the pilot project in the Netherlands. Two screening policies are compared for several discount rates, and for several exchange rates between costs and health effects.