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Strategic Distributional Cost-Effectiveness Analysis for Improving National Cancer Screening Uptake in Cervical Cancer: A Focus on Regional Inequality in South Korea

PURPOSE: The purpose of this study was to conduct a cost effectiveness analysis of strategies designed to improve national cervical cancer screening rates, along with a distributional cost effectiveness analysis that considers regional disparities. MATERIALS AND METHODS: Cost effectiveness analysis...

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Autores principales: Lee, Tae-Hoon, Kim, Woorim, Shin, Jaeyong, Park, Eun-Cheol, Park, Sohee, Kim, Tae Hyun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Cancer Association 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5784631/
https://www.ncbi.nlm.nih.gov/pubmed/28361522
http://dx.doi.org/10.4143/crt.2016.525
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author Lee, Tae-Hoon
Kim, Woorim
Shin, Jaeyong
Park, Eun-Cheol
Park, Sohee
Kim, Tae Hyun
author_facet Lee, Tae-Hoon
Kim, Woorim
Shin, Jaeyong
Park, Eun-Cheol
Park, Sohee
Kim, Tae Hyun
author_sort Lee, Tae-Hoon
collection PubMed
description PURPOSE: The purpose of this study was to conduct a cost effectiveness analysis of strategies designed to improve national cervical cancer screening rates, along with a distributional cost effectiveness analysis that considers regional disparities. MATERIALS AND METHODS: Cost effectiveness analysis was conducted using a Markov cohort simulation model, with quality adjusted life years as the unit of effectiveness. The strategies considered were current (biennial Papanicolaou smear cytology of females aged 20 or above), strong screening recommendation by mail to target regions (effect, 12% increase in screening uptake; cost, 1,000 Korean won per person), regular universal screening recommendation by mail (effect, 6% increase in screening uptake; cost, 500 Korean won per person), and strong universal screening recommendation by mail (effect, 12% increase in screening uptake; cost, 1,000 Korean won per person). Distributional cost effectiveness analysis was conducted by calculating the cost effectiveness of strategies using the Atkinson incremental cost effectiveness ratio. RESULTS: All strategies were under the threshold value, which was set as the Korean gross domestic product of $25,990. In particular, the ‘strong screening recommendation to target regions’ strategy was found to be the most cost effective (incremental cost effectiveness ratio, 7,361,145 Korean won). This was also true when societal inequality aversion increased in the distributional cost effectiveness analysis. CONCLUSION: The ‘strong screening recommendation to target regions’ strategy was the most cost effective approach, even when adjusting for inequality. As efficiency and equity are objectives concurrently sought in healthcare, these findings imply a need to develop appropriate economic evaluation methodologies to assess healthcare policies.
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spelling pubmed-57846312018-01-29 Strategic Distributional Cost-Effectiveness Analysis for Improving National Cancer Screening Uptake in Cervical Cancer: A Focus on Regional Inequality in South Korea Lee, Tae-Hoon Kim, Woorim Shin, Jaeyong Park, Eun-Cheol Park, Sohee Kim, Tae Hyun Cancer Res Treat Original Article PURPOSE: The purpose of this study was to conduct a cost effectiveness analysis of strategies designed to improve national cervical cancer screening rates, along with a distributional cost effectiveness analysis that considers regional disparities. MATERIALS AND METHODS: Cost effectiveness analysis was conducted using a Markov cohort simulation model, with quality adjusted life years as the unit of effectiveness. The strategies considered were current (biennial Papanicolaou smear cytology of females aged 20 or above), strong screening recommendation by mail to target regions (effect, 12% increase in screening uptake; cost, 1,000 Korean won per person), regular universal screening recommendation by mail (effect, 6% increase in screening uptake; cost, 500 Korean won per person), and strong universal screening recommendation by mail (effect, 12% increase in screening uptake; cost, 1,000 Korean won per person). Distributional cost effectiveness analysis was conducted by calculating the cost effectiveness of strategies using the Atkinson incremental cost effectiveness ratio. RESULTS: All strategies were under the threshold value, which was set as the Korean gross domestic product of $25,990. In particular, the ‘strong screening recommendation to target regions’ strategy was found to be the most cost effective (incremental cost effectiveness ratio, 7,361,145 Korean won). This was also true when societal inequality aversion increased in the distributional cost effectiveness analysis. CONCLUSION: The ‘strong screening recommendation to target regions’ strategy was the most cost effective approach, even when adjusting for inequality. As efficiency and equity are objectives concurrently sought in healthcare, these findings imply a need to develop appropriate economic evaluation methodologies to assess healthcare policies. Korean Cancer Association 2018-01 2017-03-30 /pmc/articles/PMC5784631/ /pubmed/28361522 http://dx.doi.org/10.4143/crt.2016.525 Text en Copyright © 2018 by the Korean Cancer Association This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lee, Tae-Hoon
Kim, Woorim
Shin, Jaeyong
Park, Eun-Cheol
Park, Sohee
Kim, Tae Hyun
Strategic Distributional Cost-Effectiveness Analysis for Improving National Cancer Screening Uptake in Cervical Cancer: A Focus on Regional Inequality in South Korea
title Strategic Distributional Cost-Effectiveness Analysis for Improving National Cancer Screening Uptake in Cervical Cancer: A Focus on Regional Inequality in South Korea
title_full Strategic Distributional Cost-Effectiveness Analysis for Improving National Cancer Screening Uptake in Cervical Cancer: A Focus on Regional Inequality in South Korea
title_fullStr Strategic Distributional Cost-Effectiveness Analysis for Improving National Cancer Screening Uptake in Cervical Cancer: A Focus on Regional Inequality in South Korea
title_full_unstemmed Strategic Distributional Cost-Effectiveness Analysis for Improving National Cancer Screening Uptake in Cervical Cancer: A Focus on Regional Inequality in South Korea
title_short Strategic Distributional Cost-Effectiveness Analysis for Improving National Cancer Screening Uptake in Cervical Cancer: A Focus on Regional Inequality in South Korea
title_sort strategic distributional cost-effectiveness analysis for improving national cancer screening uptake in cervical cancer: a focus on regional inequality in south korea
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5784631/
https://www.ncbi.nlm.nih.gov/pubmed/28361522
http://dx.doi.org/10.4143/crt.2016.525
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