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- Cost Effectiveness of Interventions to Promote Screening for Colorectal Cancer: A Randomized Trial
- Swati Misra, David R. Lairson, Wenyaw Chan, Yu-Chia Chang, L. Kay Bartholomew, Anthony Greisinger, Amy McQueen, Sally W. Vernon
- J Prev Med Public Health. 2011;44(3):101-110. Published online May 17, 2010
- DOI: https://doi.org/10.3961/jpmph.2011.44.3.101
- 12,694 View
- 98 Download
- 15 Crossref
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Abstract
PDF Objectives Screening for colorectal cancer is considered cost effective, but is underutilized in the U.S. Information on the efficiency of "tailored interventions" to promote colorectal cancer screening in primary care settings is limited. The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control (CDC) web-based intervention (screen for life) and to a tailored interactive computer-based intervention.
Methods A randomized controlled trial of people 50 and over, was conducted to test the interventions. The sample was 1224 partcipants 50-70 years of age, recruited from Kelsey-Seybold Clinic, a large multi-specialty clinic in Houston, Texas. Screening status was obtained by medical chart review after a 12-month follow-up period. An "intention to treat" analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects. Analysis of statistical uncertainty was conducted using nonparametric bootstrapping.
Results The estimated cost of implementing the web-based intervention was $40 per person and the cost of the tailored intervention was $45 per person. The additional cost per person screened for the web-based intervention compared to no intervention was $2602 and the tailored intervention was no more effective than the web-based strategy.
Conclusions The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion. The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion. Researchers need to continue developing and evaluating the effectiveness and cost-effectiveness of interventions to increase colorectal cancer screening.
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Summary
Citations
Citations to this article as recorded by
- Extending analytic methods for economic evaluation in implementation science
Meghan C. O’Leary, Kristen Hassmiller Lich, Leah Frerichs, Jennifer Leeman, Daniel S. Reuland, Stephanie B. Wheeler
Implementation Science.2022;[Epub] CrossRef - Interventions for increasing colorectal cancer screening uptake among African-American men: A systematic review and meta-analysis
Charles R. Rogers, Phung Matthews, Lei Xu, Kenneth Boucher, Colin Riley, Matthew Huntington, Nathan Le Duc, Kola S. Okuyemi, Margaret J. Foster, Joseph Telfair
PLOS ONE.2020; 15(9): e0238354. CrossRef - Economic Evaluation of Tailored Web versus Tailored Telephone-Based Interventions to Increase Colorectal Cancer Screening among Women
David R. Lairson, Tong Han Chung, Danmeng Huang, Timothy E. Stump, Patrick O. Monahan, Shannon M. Christy, Susan M. Rawl, Victoria L. Champion
Cancer Prevention Research.2020; 13(3): 309. CrossRef - Economics of Multicomponent Interventions to Increase Breast, Cervical, and Colorectal Cancer Screening: A Community Guide Systematic Review
Giridhar Mohan, Sajal K. Chattopadhyay, Donatus U. Ekwueme, Susan A. Sabatino, Devon L. Okasako-Schmucker, Yinan Peng, Shawna L. Mercer, Anilkrishna B. Thota
American Journal of Preventive Medicine.2019; 57(4): 557. CrossRef - Colorectal cancer screening interventions in 2 health care systems serving disadvantaged populations: Screening uptake and cost‐effectiveness
Christen L. Lara, Kelly L. Means, Krystal D. Morwood, Westley R. Lighthall, Sonja Hoover, Florence K.L. Tangka, Cynthia French, Krystal D. Gayle, Amy DeGroff, Sujha Subramanian
Cancer.2018; 124(21): 4130. CrossRef - The cost of implementing two small media interventions to promote HPV vaccination
Siddharth S. Karanth, David R. Lairson, Danmeng Huang, Lara S. Savas, Sally W. Vernon, María E. Fernández
Preventive Medicine.2017; 99: 277. CrossRef - An Economic Evaluation of Colorectal Cancer Screening in Primary Care Practice
Richard T. Meenan, Melissa L. Anderson, Jessica Chubak, Sally W. Vernon, Sharon Fuller, Ching-Yun Wang, Beverly B. Green
American Journal of Preventive Medicine.2015; 48(6): 714. CrossRef - Optimising colorectal cancer screening acceptance: a review
Carlo Senore, John Inadomi, Nereo Segnan, Cristina Bellisario, Cesare Hassan
Gut.2015; 64(7): 1158. CrossRef - Get Screened: A Randomized Trial of the Incremental Benefits of Reminders, Recall, and Outreach on Cancer Screening
Robert J. Fortuna, Amna Idris, Paul Winters, Sharon G. Humiston, Steven Scofield, Samantha Hendren, Patricia Ford, Shirley X. L. Li, Kevin Fiscella
Journal of General Internal Medicine.2014; 29(1): 90. CrossRef - Public Awareness of Colorectal Cancer Screening: Knowledge, Attitudes, and Interventions for Increasing Screening Uptake
Antonio Z. Gimeno Garcia, Noemi Hernandez Alvarez Buylla, David Nicolas-Perez, Enrique Quintero
ISRN Oncology.2014; 2014: 1. CrossRef - Cost‐effectiveness of a standard intervention versus a navigated intervention on colorectal cancer screening use in primary care
David R. Lairson, Melissa DiCarlo, Ashish A. Deshmuk, Heather B. Fagan, Randa Sifri, Nora Katurakes, James Cocroft, Jocelyn Sendecki, Heidi Swan, Sally W. Vernon, Ronald E. Myers
Cancer.2014; 120(7): 1042. CrossRef - Communication preference moderates the effect of a tailored intervention to increase colorectal cancer screening among African Americans
Ken Resnicow, Yan Zhou, Sarah Hawley, Masahito Jimbo, Mack T. Ruffin, Rachel E. Davis, Deirdre Shires, Jennifer Elston Lafata
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Mary Anne T Dallat, Ruth F Hunter, Mark A Tully, Karen J Cairns, Frank Kee
BMC Public Health.2013;[Epub] CrossRef - Personalised risk communication for informed decision making about taking screening tests
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Cochrane Database of Systematic Reviews.2013;[Epub] CrossRef - Colorectal Cancer in the Kingdom of Saudi Arabia: Need for Screening
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English Abstracts- Current State and Challenges of Pharmacoeconomic Evaluation in Korea.
- Sang Eun Choi
- J Prev Med Public Health. 2008;41(2):74-79.
- DOI: https://doi.org/10.3961/jpmph.2008.41.2.74
- 4,034 View
- 46 Download
- 3 Crossref
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Abstract
PDF
- Since the positive listing system for prescription drug reimbursement has been introduced in Korea, the number of pharmacoeconomic evaluation studies has increased. However it is not clear if the quality of pharmacoeconomic evaluation study has improved. Due to the lack of randomized clinical studies in Korean health care setting, Korean economic evaluation studies have typically integrated the local cost data and foreign clinical data. Therefore methodological issues can be raised in regard to data coherence and consistency. But the quality of data was not questiened and the potential bias has not been investigated yet. Even though changes in policy have encouraged the undertaking of pharmacoeconomic evaluations, there is few public-side funding for validation study of cost-effectiveness models and data. Several companies perform economic evaluation studies to be submitted on behalf of their own products, but do not want the study results to be disclosed to the academic community or public. To improve the present conduct of pharmacoeconomic evaluations in Korea, various funding sources need to be developed, and, like other multidisciplinary areas, the experts in different fields of study should collaborate to ensure the validity and credibility of pharmacoeconomic evaluations.
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Summary
Citations
Citations to this article as recorded by- Barriers and Facilitators of Pharmacoeconomic Studies: A Review of Evidence from the Middle Eastern Countries
Abdulaziz Ibrahim Alzarea, Yusra Habib Khan, Abdullah Salah Alanazi, Muhammad Hammad Butt, Ziyad Saeed Almalki, Abdullah K. AlAhmari, Saud Alsahali, Tauqeer Hussain Mallhi
International Journal of Environmental Research and Public Health.2022; 19(13): 7862. CrossRef - Barriers to implementing pharmacoeconomics: interview study
Qais Alefan, Esra’a Hamdouni, Hamza Alhamad, Tareq Mukattash, Karen Rascati
Expert Review of Pharmacoeconomics & Outcomes Research.2021; 21(1): 93. CrossRef - Pharmaceutical Policy Reforms to Regulate Drug Prices in the Asia Pacific Region: The Case of Australia, China, India, Malaysia, New Zealand, and South Korea
Syed Shahzad Hasan, Chia Siang Kow, Dalia Dawoud, Omneya Mohamed, Darrin Baines, Zaheer-Ud-Din Babar
Value in Health Regional Issues.2019; 18: 18. CrossRef
- Use of Economic Evaluation in the Listing and Pricing of Pharmaceuticals.
- Tae Jin Lee
- J Prev Med Public Health. 2008;41(2):69-73.
- DOI: https://doi.org/10.3961/jpmph.2008.41.2.69
- 4,379 View
- 50 Download
- 5 Crossref
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Abstract
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- To curb a rapid increase in expenditures for pharmaceuticals, the Korean government introduced a positive list system and a negotiation process for drug prices at the end of 2006. Economic evaluation of pharmaceuticals has begun to have a pivotal role in the listing and pricing of drugs for the Korean National Health Insurance. There are some points to discuss regarding the use of economic evaluation in the listing and pricing in the context of the Korean system. First, the listing and pricing processes have been fragmented, evoking complaints from pharmaceutical companies and delaying the access of new drugs to patients. Second, there is a concern that the positive list system may limit the range and availability of drugs for patients to choose for treatment. Third, the time schedule for de-listing of existing drugs may not be realistic. Fourth, it is not always easy to provide reliable evidence of cost-effectiveness due to a lack of materials. Fifth, there is no consensus on the range of the ICER (incremental cost-effectiveness ratio) acceptable to the Korean society. In conclusion, in the near future, it will be necessary to evaluate the achievements that the economic evaluation has provided to the Korean society.
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Summary
Citations
Citations to this article as recorded by- Cost-effectiveness of rhythm control strategy: Ablation versus antiarrhythmic drugs for treating atrial fibrillation in Korea based on real-world data
Woojin Kim, Min Kim, Yun Tae Kim, Woongbi Park, Jin-bae Kim, Changsoo Kim, Boyoung Joung
Frontiers in Cardiovascular Medicine.2023;[Epub] CrossRef - Policy Suggestions to Improve Patient Access to New Drugs in Korea
Yoona Choi, Howard Lee
Korean Journal of Clinical Pharmacy.2021; 31(1): 1. CrossRef - Consistency of new drug pricing in Korea: Bridging variations among personnel in price negotiations
Hye-Young Kwon, Jinhyun Kim
Health Policy.2020; 124(9): 965. CrossRef - How Much Amount of Socioeconomic Loss Is Caused by Digestive Diseases?
Kyung Sik Park
The Korean Journal of Gastroenterology.2011; 58(6): 297. CrossRef - Health Care Costs of Digestive Diseases in Korea
Hye-kyung Jung, BoHyoung Jang, Youn Hee Kim, JooYeon Park, Sun Young Park, Mi-Hee Nam, Myung-Gyu Choi
The Korean Journal of Gastroenterology.2011; 58(6): 323. CrossRef
Original Articles- Cost-Effectiveness Analysis of a Hyperlipidemia Mass Screening Program in Korea.
- Yeon Soon Cha, Young Ho Khang, Moo Song Lee, Weechang Kang, Sung Hoon Jeon, Kee Lak Kim, Sang Il Lee
- Korean J Prev Med. 2002;35(2):99-106.
- 2,428 View
- 35 Download
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Abstract
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- OBJECTIVE
Until now, there have been no evidence-based guidelines produced for the mass screening of hyperlipidemia cases in Korea. This study was done to find the most efficient strategy for a hyperlipidemia-screening program among Korean adults. METHOD: Seven alternative strategies for hyperlipidemia screening were formulated and compared in terms of cost-effectiveness. Cost and effectiveness were estimated from social perspectives and using a two-stage screening process (initial testing and additional testing for positives from the first test). A computerized database (based on persons who had visited a health promotion center in one teaching hospital for a routine health check-up) was used to determine the cost and the outcome of various strategies. Official data was used in calculating direct and indirect costs. Effectiveness was measured according to the number of persons who needed clinical intervention for hyperlipidemia. A stratified analysis, considering age group and sex, was then done. Sensitivity analyses, focusing on several uncertain parameters, were also done. RESULTS: Of the seven test alternatives available, the most cost-effective strategy was a screening program, which consisted of an initial test of total cholesterol,high-density lipoprotein cholesterol and triglyceride. There was some variation in the rank of the cost-effectiveness ratios for the seven alternatives dependent on age group or gender. CONCLUSIONS: Current hyperlipidemia screening practice, for National Health Insurance beneficiaries, tests only the total cholesterol level with a cut-off value of 260mg/dl as an initial screening test. It is not the best strategy for cost-effectiveness, and should be modified. Different screening strategies taking age group and sex into account should be developed and used for the efficient mass screening of hyperlipidemia cases among Korean adults. -
Summary
- Cost analysis of hypertension screening program.
- Eun Cheol Park, Seung Hum Yu
- Korean J Prev Med. 1989;22(3):380-388.
- 2,121 View
- 29 Download
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Abstract
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- To evaluate the costs the hypertension screening program of the Korea Medical Insurance Corporation, the records of the screening examinations were used. The sample size was 49,983 of the 906,554 people insured by the Corporation and was obtained by two-stage stratification random sampling. The alternatives for efficiency of the screening program, which were divided into three categories: modification of the screening test package, application of other hypertension diagnostic criteria, and selective approach of tested groups by age, were evaluated according to the cost per patient detected. The results of this study were as follows: In the hypertension screening system, the cost per patient detected was Won 30,833. The most nonsensitive test for hypertension detection was ophthalmoscopy, which was examine during the second stage of screening. If the ophthalmoscope examination was excluded, only one person was not detected, which was 0.2% of detected persons, and the cost per patient detected decreased to Won 28,098. The most efficient modification of the screening test package was measurement of blood pressure through the first and second stages of screening. The cost per patient detected by this modification was Won 24,408. The application of other diagnostic criteria, which were more restricted criteria, increased the cost per patient detected by 3.7%-6.7%. The cost per patient detected were Won 170,582 for persons less than 39 years old, Won 20,032 for persons 40 to 59 years old, and Won 8,675 for persons 60 years old and over. In conclusion, the best alternative suggested with respect to efficiency and practical application excluded the ophthalmoscope examination of second stage screening and restricted the target population to persons greater than 40 years old. The application of this alternative decreased 54.9% of the screening costs and the cost per patient detected was Won 15,222. This study was limited in that measurement of effectiveness was not of the ultimate goal of screening, which is decreasing morbidity and mortality, but was of disease detection as the short-term objective.
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