Dr Richard Jaine, Dr Giorgi Kvizhinadze, Prof Nick Wilson, Prof Tony Blakely
There is reasonably strong evidence screening for lung cancer with low-dose computed tomography (LDCT) scans is effective at reducing lung cancer mortality. However, new research suggests it is highly unlikely to be cost-effective in NZ. We have just published the first NZ study to examine the cost-effectiveness of lung cancer screening in the journal Lung Cancer, and we estimate that it would cost NZ$154,000 per quality-adjusted life-year (QALY) gained – even among heavy smokers . This means that gaining the equivalent of one year of life in perfect health from lung cancer screening comes with a price tag of about $150,000. This suggests that if we want to reduce the burden of lung cancer in NZ but still have to work within a finite health budget, we should consider more cost-effective means (e.g. enhanced tobacco control).
By the BODE3 Programme Team*
In this blog we describe an online calculator we developed to estimate the maximum investment society might consider spending on life-saving health interventions, while remaining cost-effective. For NZ, the amounts generated by this calculator vary greatly by age: NZ$ 1.2 million for an intervention to save the life of a child, NZ$ 0.7 million for a 50-year-old, and NZ$ 0.2 million for an 80-year-old, assuming we are willing to spend $45,000 per healthy life-years gained and the person is returned to the expected health status of the average NZ citizen. These results are very sensitive to the choice of discount rate and to the selected cost-effectiveness threshold. Policy-makers could use this calculator as a rapid screening tool to determine if more detailed cost-effectiveness analyses of potential life-saving interventions might be worthwhile.