Budget impact analysis of implementing a lung cancer screening in high-risk population in Spain

Objective: To analyze the cost of implementing a population-based lung cancer screening program using low-dose radiation computed tomography (CT) in a high-risk population in Spain. Method: A budget impact analysis (5 years) was performed from the National Health System’ perspective, comparing 16 hy...

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Main Authors: Aránzazu Hernández-Yumar, Cristina Valcárcel-Nazco, Paula Cantero-Muñoz, Lidia García-Pérez
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Gaceta Sanitaria
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Online Access:http://www.sciencedirect.com/science/article/pii/S021391112500069X
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author Aránzazu Hernández-Yumar
Cristina Valcárcel-Nazco
Paula Cantero-Muñoz
Lidia García-Pérez
author_facet Aránzazu Hernández-Yumar
Cristina Valcárcel-Nazco
Paula Cantero-Muñoz
Lidia García-Pérez
author_sort Aránzazu Hernández-Yumar
collection DOAJ
description Objective: To analyze the cost of implementing a population-based lung cancer screening program using low-dose radiation computed tomography (CT) in a high-risk population in Spain. Method: A budget impact analysis (5 years) was performed from the National Health System’ perspective, comparing 16 hypothetical scenarios with screening, based on different age ranges and screening frequencies (annual/biennial), with the current scenario without a lung cancer screening program. Diagnosis, treatment and follow-up costs were considered, as well as the screening costs in the hypothetical scenarios (measured in Euros 2024). From the resident population (50-80 years), the target population and the CT scanners needed to cover the program's demand were calculated. A one-way deterministic sensitivity analysis was performed. Results: The gross budget impact was estimated at €1708.19 million for the current scenario. Among the hypothetical scenarios, it can range from €3737.17 million (biennial screening, 55-65 years) to €10 009.54 million (annual screening, 50-80 years), resulting in a net budget impact of €2028.98-€8301.35 million. By acquiring 100% of the necessary scanners, the investment reached approximately 22% of the annual program's own costs in the first year. The net impact could be reduced to €1858-€7519 million, for 0% acquisition. Conclusions: Implementing a lung cancer screening program would generate a high cost for the Spanish National Health System, amounting more than one billion Euros compared to the scenario without screening. Resumen: Objetivo: Analizar el coste de un programa de cribado de cáncer de pulmón mediante tomografía computarizada (TC) de baja dosis de radiación en población de alto riesgo en España. Método: Se realizó un análisis de impacto presupuestario (5 años) desde la perspectiva del Sistema Nacional de Salud, comparando 16 escenarios hipotéticos de cribado (diferentes rangos de edad y frecuencias de cribado anual o bienal) con el escenario actual sin cribado. Se consideraron los costes de diagnóstico, tratamiento y seguimiento, así como los costes del cribado en los escenarios hipotéticos (euros de 2024). Se estimaron la población diana y los equipos de TC necesarios para el programa. Se realizó un análisis de sensibilidad. Resultados: El impacto presupuestario bruto se estimó en 1708,19 millones de euros (M€) para el escenario actual. En los escenarios hipotéticos, puede oscilar entre 3737,17 M€ (cribado bienal, 55-65 años) y 10.009,54 M€ (cribado anual, 50-80 años), suponiendo un impacto presupuestario neto de 2028,98-8301,35 M€. Adquiriendo el 100% de los escáneres necesarios, la inversión alcanzaría aproximadamente el 22% de los costes anuales propios del programa (año 1). El impacto neto podría reducirse a 1858-7519 M€ para una adquisición del 0%. Conclusiones: Implantar un programa de cribado de cáncer de pulmón generaría un coste elevado para el Sistema Nacional de Salud español, superior a los 1000 millones de euros respecto al escenario sin cribado.
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spelling doaj-art-706fbb4b3fba43c398db5ef5c1255fb02025-08-20T03:39:04ZengElsevierGaceta Sanitaria0213-91112025-01-013910251510.1016/j.gaceta.2025.102515Budget impact analysis of implementing a lung cancer screening in high-risk population in SpainAránzazu Hernández-Yumar0Cristina Valcárcel-Nazco1Paula Cantero-Muñoz2Lidia García-Pérez3Canary Islands Health Research Institute Foundation, Tenerife, Spain; Evaluation Unit, Canary Islands Health Service, Tenerife, Spain; Spanish Network of Agencies for Assessing National Health System Technologies and Performance (RedETS), Madrid, SpainCanary Islands Health Research Institute Foundation, Tenerife, Spain; Evaluation Unit, Canary Islands Health Service, Tenerife, Spain; Spanish Network of Agencies for Assessing National Health System Technologies and Performance (RedETS), Madrid, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain; Corresponding author.Spanish Network of Agencies for Assessing National Health System Technologies and Performance (RedETS), Madrid, Spain; Unidade de Asesoramento Científico-Técnico (Avalia-t), Axencia Galega de Coñecemento en Saúde, Santiago de Compostela (A Coruña), SpainCanary Islands Health Research Institute Foundation, Tenerife, Spain; Evaluation Unit, Canary Islands Health Service, Tenerife, Spain; Spanish Network of Agencies for Assessing National Health System Technologies and Performance (RedETS), Madrid, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, SpainObjective: To analyze the cost of implementing a population-based lung cancer screening program using low-dose radiation computed tomography (CT) in a high-risk population in Spain. Method: A budget impact analysis (5 years) was performed from the National Health System’ perspective, comparing 16 hypothetical scenarios with screening, based on different age ranges and screening frequencies (annual/biennial), with the current scenario without a lung cancer screening program. Diagnosis, treatment and follow-up costs were considered, as well as the screening costs in the hypothetical scenarios (measured in Euros 2024). From the resident population (50-80 years), the target population and the CT scanners needed to cover the program's demand were calculated. A one-way deterministic sensitivity analysis was performed. Results: The gross budget impact was estimated at €1708.19 million for the current scenario. Among the hypothetical scenarios, it can range from €3737.17 million (biennial screening, 55-65 years) to €10 009.54 million (annual screening, 50-80 years), resulting in a net budget impact of €2028.98-€8301.35 million. By acquiring 100% of the necessary scanners, the investment reached approximately 22% of the annual program's own costs in the first year. The net impact could be reduced to €1858-€7519 million, for 0% acquisition. Conclusions: Implementing a lung cancer screening program would generate a high cost for the Spanish National Health System, amounting more than one billion Euros compared to the scenario without screening. Resumen: Objetivo: Analizar el coste de un programa de cribado de cáncer de pulmón mediante tomografía computarizada (TC) de baja dosis de radiación en población de alto riesgo en España. Método: Se realizó un análisis de impacto presupuestario (5 años) desde la perspectiva del Sistema Nacional de Salud, comparando 16 escenarios hipotéticos de cribado (diferentes rangos de edad y frecuencias de cribado anual o bienal) con el escenario actual sin cribado. Se consideraron los costes de diagnóstico, tratamiento y seguimiento, así como los costes del cribado en los escenarios hipotéticos (euros de 2024). Se estimaron la población diana y los equipos de TC necesarios para el programa. Se realizó un análisis de sensibilidad. Resultados: El impacto presupuestario bruto se estimó en 1708,19 millones de euros (M€) para el escenario actual. En los escenarios hipotéticos, puede oscilar entre 3737,17 M€ (cribado bienal, 55-65 años) y 10.009,54 M€ (cribado anual, 50-80 años), suponiendo un impacto presupuestario neto de 2028,98-8301,35 M€. Adquiriendo el 100% de los escáneres necesarios, la inversión alcanzaría aproximadamente el 22% de los costes anuales propios del programa (año 1). El impacto neto podría reducirse a 1858-7519 M€ para una adquisición del 0%. Conclusiones: Implantar un programa de cribado de cáncer de pulmón generaría un coste elevado para el Sistema Nacional de Salud español, superior a los 1000 millones de euros respecto al escenario sin cribado.http://www.sciencedirect.com/science/article/pii/S021391112500069XDetección temprana del cáncerNeoplasias pulmonaresAnálisis de impacto presupuestarioProgramas de cribadoProgramas de salud nacionalesEspaña
spellingShingle Aránzazu Hernández-Yumar
Cristina Valcárcel-Nazco
Paula Cantero-Muñoz
Lidia García-Pérez
Budget impact analysis of implementing a lung cancer screening in high-risk population in Spain
Gaceta Sanitaria
Detección temprana del cáncer
Neoplasias pulmonares
Análisis de impacto presupuestario
Programas de cribado
Programas de salud nacionales
España
title Budget impact analysis of implementing a lung cancer screening in high-risk population in Spain
title_full Budget impact analysis of implementing a lung cancer screening in high-risk population in Spain
title_fullStr Budget impact analysis of implementing a lung cancer screening in high-risk population in Spain
title_full_unstemmed Budget impact analysis of implementing a lung cancer screening in high-risk population in Spain
title_short Budget impact analysis of implementing a lung cancer screening in high-risk population in Spain
title_sort budget impact analysis of implementing a lung cancer screening in high risk population in spain
topic Detección temprana del cáncer
Neoplasias pulmonares
Análisis de impacto presupuestario
Programas de cribado
Programas de salud nacionales
España
url http://www.sciencedirect.com/science/article/pii/S021391112500069X
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