Budget impact analysis of introducing digital breast tomosynthesis in breast cancer screening in Italy
(2024) In Radiologia Medica 129(9). p.1288-1302- Abstract
Purpose: This study quantifies the impact on budget and cost per health benefit of implementing digital breast tomosynthesis (DBT) in place of digital mammography (DM) for breast cancer screening among asymptomatic women in Italy. Methods: A budget impact analysis and a cost consequence analysis were conducted using parameters from the MAITA project and literature. The study considered four scenarios for DBT implementation, i.e., DBT for all women, DBT for women aged 45–49 years, DBT based on breast density (BI-RADS C + D or D only), and compared these to the current DM screening. Healthcare provider's perspective was adopted, including screening, diagnosis, and cancer treatment costs. Results: Introducing DBT for all women would... (More)
Purpose: This study quantifies the impact on budget and cost per health benefit of implementing digital breast tomosynthesis (DBT) in place of digital mammography (DM) for breast cancer screening among asymptomatic women in Italy. Methods: A budget impact analysis and a cost consequence analysis were conducted using parameters from the MAITA project and literature. The study considered four scenarios for DBT implementation, i.e., DBT for all women, DBT for women aged 45–49 years, DBT based on breast density (BI-RADS C + D or D only), and compared these to the current DM screening. Healthcare provider's perspective was adopted, including screening, diagnosis, and cancer treatment costs. Results: Introducing DBT for all women would increase overall screening costs by 20%. Targeting DBT to women aged 45–49 years or with dense breasts would result in smaller cost increases (3.2% for age-based and 1.4–10.7% for density-based scenarios). The cost per avoided interval cancer was significantly higher when DBT was applied to all women compared to targeted approaches. The cost per gained early-detected cancer slightly increases in targeted approaches, while the assumptions on the clinical significance and overdiagnosis of cancers detected by DBT and not by DM have a strong impact. Conclusions: Implementing DBT as a primary breast cancer test in screening programs in Italy would lead to a substantial increase in costs. Tailoring DBT use to women aged 45–49 or with dense breasts could enhance the feasibility and sustainability of the intervention. Further research is needed to clarify the impact of DBT on overdiagnosis and the long-term outcomes.
(Less)
- author
- contributor
- Lang, Kristina LU
- author collaboration
- organization
- publishing date
- 2024-09
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Breast neoplasms, Budget impact analysis, Cost, Digital breast tomosynthesis, Digital mammography, Mass screening
- in
- Radiologia Medica
- volume
- 129
- issue
- 9
- pages
- 1288 - 1302
- publisher
- Edizioni Minerva Medica
- external identifiers
-
- pmid:39162938
- scopus:85203315927
- ISSN
- 0033-8362
- DOI
- 10.1007/s11547-024-01850-7
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © Italian Society of Medical Radiology 2024.
- id
- d9b973af-15a4-4783-95a7-f2001f6e2c1d
- date added to LUP
- 2024-09-16 20:19:08
- date last changed
- 2024-09-17 16:23:16
@article{d9b973af-15a4-4783-95a7-f2001f6e2c1d,
abstract = {{<p>Purpose: This study quantifies the impact on budget and cost per health benefit of implementing digital breast tomosynthesis (DBT) in place of digital mammography (DM) for breast cancer screening among asymptomatic women in Italy. Methods: A budget impact analysis and a cost consequence analysis were conducted using parameters from the MAITA project and literature. The study considered four scenarios for DBT implementation, i.e., DBT for all women, DBT for women aged 45–49 years, DBT based on breast density (BI-RADS C + D or D only), and compared these to the current DM screening. Healthcare provider's perspective was adopted, including screening, diagnosis, and cancer treatment costs. Results: Introducing DBT for all women would increase overall screening costs by 20%. Targeting DBT to women aged 45–49 years or with dense breasts would result in smaller cost increases (3.2% for age-based and 1.4–10.7% for density-based scenarios). The cost per avoided interval cancer was significantly higher when DBT was applied to all women compared to targeted approaches. The cost per gained early-detected cancer slightly increases in targeted approaches, while the assumptions on the clinical significance and overdiagnosis of cancers detected by DBT and not by DM have a strong impact. Conclusions: Implementing DBT as a primary breast cancer test in screening programs in Italy would lead to a substantial increase in costs. Tailoring DBT use to women aged 45–49 or with dense breasts could enhance the feasibility and sustainability of the intervention. Further research is needed to clarify the impact of DBT on overdiagnosis and the long-term outcomes.</p>}},
author = {{Djuric, Olivera and Deandrea, Silvia and Mantellini, Paola and Sardanelli, Francesco and Venturelli, Francesco and Montemezzi, Stefania and Vecchio, Riccardo and Bucchi, Lauro and Senore, Carlo and Giordano, Livia and Paci, Eugenio and Bonifacino, Adriana and Calabrese, Massimo and Caumo, Francesca and Degrassi, Flori and Sassoli de’ Bianchi, Priscilla and Battisti, Francesca and Zappa, Marco and Pattacini, Pierpaolo and Campari, Cinzia and Nitrosi, Andrea and Di Leo, Giovanni and Frigerio, Alfonso and Magni, Veronica and Fornasa, Francesca and Romanucci, Giovanna and Falini, Patrizia and Auzzi, Noemi and Armaroli, Paola and Giorgi Rossi, Paolo}},
issn = {{0033-8362}},
keywords = {{Breast neoplasms; Budget impact analysis; Cost; Digital breast tomosynthesis; Digital mammography; Mass screening}},
language = {{eng}},
number = {{9}},
pages = {{1288--1302}},
publisher = {{Edizioni Minerva Medica}},
series = {{Radiologia Medica}},
title = {{Budget impact analysis of introducing digital breast tomosynthesis in breast cancer screening in Italy}},
url = {{http://dx.doi.org/10.1007/s11547-024-01850-7}},
doi = {{10.1007/s11547-024-01850-7}},
volume = {{129}},
year = {{2024}},
}