Cost-effectiveness of organised versus opportunistic mammography breast cancer screening in low-resourced country.
Biennial mammography screening ages 50-65 is cost-effective versus opportunistic screening in Jordan
Cost-effectiveness of organised versus opportunistic mammography breast cancer screening in low-resourced country.
To assess the cost-effectiveness of expanding the current opportunistic screening strategy to an organised and feasible population-based breast cancer screening strategy from the healthcare system perspective in Jordan.
The model includes a hypothetical cohort of average-risk asymptomatic Jordanian women aged 40 years and above.
Over a lifetime horizon, strategy 3 (50-65 biennial, 50% attendance rate) resulted in a mean discounted life years of 22.077, a mean discounted quality-adjusted life years of 16.993 and a mean discounted cost of US$994 compared with opportunistic screening, which resulted in a mean discounted life years of 22.062, a mean discounted quality-adjusted life years of 16.980 and a mean discounted cost of US$889.
Strategy 3 ranks first as the most cost-effective organised screening strategy for the Jordanian healthcare system, followed by strategy 4 with an incremental cost-utility ratio of US$18 024 per quality-adjusted life years and strategy 6 with an incremental cost-utility ratio of US$62 418 per quality-adjusted life years.
At a willingness-to-pay cost-effectiveness threshold of US$42000-56000 per quality-adjusted life years, strategy 3 (50-65 biennial, 50% attendance rate) and strategy 4 (40-70 biennial, 50% attendance rate) are likely to be cost-effective in Jordan.
However, prior to implementation, the affordability of each strategy and the availability of required infrastructure must be carefully evaluated.