Cost-Effectiveness of Increasing Access to Colorectal Cancer Diagnosis: Analysis From Thailand
Issued Date
2024-09-01
Resource Type
ISSN
22121099
eISSN
22121102
Scopus ID
2-s2.0-85195034069
Journal Title
Value in Health Regional Issues
Volume
43
Rights Holder(s)
SCOPUS
Bibliographic Citation
Value in Health Regional Issues Vol.43 (2024)
Suggested Citation
Wongseree P., Hasgul Z., Jalali M.S. Cost-Effectiveness of Increasing Access to Colorectal Cancer Diagnosis: Analysis From Thailand. Value in Health Regional Issues Vol.43 (2024). doi:10.1016/j.vhri.2024.101010 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/98682
Title
Cost-Effectiveness of Increasing Access to Colorectal Cancer Diagnosis: Analysis From Thailand
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Abstract
Objectives: The purpose of this study is to evaluate the cost-effectiveness of increasing access to colorectal cancer (CRC) diagnosis, considering resource limitations in Thailand. Methods: We analyzed the cost-effectiveness of increasing access to fecal immunochemical test screening (strategy I), symptom evaluation (strategy II), and their combination through healthcare and societal perspectives using Colo-Sim, a simulation model of CRC care. We extended our analysis by adding a risk-stratification score (RS) to the strategies. We analyzed all strategies under the currently limited annual colonoscopy capacity and sufficient capacity. We estimated quality-adjusted life-years (QALYs) and costs over 2023 to 2047 and performed sensitivity analyses. Results: Annual costs for CRC care will increase over 25 years in Thailand, resulting in a cumulative cost of 323B Thai baht (THB). Each strategy results in higher QALYs gained and additional costs. With the current colonoscopy capacity and willingness-to-pay threshold of 160 000 THB, strategy I with and without RS is not cost-effective. Strategy II + RS is the most cost-effective, resulting in 0.68 million QALYs gained with additional costs of 66B THB. Under sufficient colonoscopy capacity, all strategies are deemed cost-effective, with the combined approach (strategy I + II + RS) being the most favorable, achieving the highest QALYs (1.55 million) at an additional cost of 131 billion THB. This strategy also maintains the highest probability of being cost-effective at any willingness-to-pay threshold above 96 000 THB. Conclusions: In Thailand, fecal immunochemical test screening, symptom evaluation, and RS use can achieve the highest QALYs; however, boosting colonoscopy capacity is essential for cost-effectiveness.