Cost-effectiveness of MR-mammography vs. conventional mammography in screening patients at intermediate risk of breast cancer - A model-based economic evaluation. Issue 136 (March 2021)

• Record Type: Journal Article
• Authors: Kaiser, Clemens G.; Dietzel, Matthias; Vag, Tibor; Froelich, Matthias F.
• Is Part Of: European journal of radiology. Issue 136(2021)
• Publication Date: 2021-03
• Subjects: MRM MR-Mammography -- XM X-Ray based mammographie -- QALY Quality-adjusted life year -- WTP Willingness to pay -- ICER Incremental cost-effectiveness ratio; MR-Mammography -- Cost-effectiveness -- Mammography -- Breast cancer -- Screening -- Intermediate risk; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2020.109355
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Screening women with intermediate risk for breast cancer with MR-mammography is associated with increased quality of life. The incremental cost-effectiveness ratio of MR-mammography was lower than willingness-to-pay thresholds. From an economical perspective, MR-mammography is feasible for screening patients at intermediate risk for breast cancer. Abstract: Purpose: The aim of this study was to analyze the cost-effectiveness of screening patients of intermediate risk of breast cancer with MR-Mammography (MRM) versus conventional mammography (XM). Method: A decision model for both diagnostic modalities and a subsequent markov model for the simulation of follow-up costs and outcomes was developed. Input parameters were acquired from published literature for this markov modelling study. The expected cumulative costs and outcomes were calculated for both modalities in a 30-year timeframe in US-dollar ($) and quality-adjusted life years (QALYs). A deterministic sensitivity analysis and a probabilistic sensitivity analysis incorporating 30, 000 Monte Carlo iterations were performed to investigate the model stability. Results: In total, XM with its consecutive treatments resulted in total costs of $ 5, 492.68 and an average cumulative quality of life of 18.87 QALYs, compared to MRM with costs of $ 5, 878.66 and 18.92 QALYs. The corresponding incremental cost-effectiveness ratio (ICER) for MRM was $ 8, 797.60 per QALY - distinctly below international willingness-to-pay thresholds for cost-effectiveness. The results were confirmed within the limits of the sensitivity analyses. Conclusions: In patients with intermediate risk for breast cancer due to their dense breast tissue, two-yearly screening with MRM may be considered as cost-effective.