The cost-effectiveness of screening programs using single and multiple birth cohort simulations: a comparison using a model of cervical cancer

Medical Decision Making : an International Journal of the Society for Medical Decision Making
Sarah Dewilde, Rob Anderson

Abstract

Despite early recognition of the theoretical advantages of simulations that include different population subgroups/ strata and different birth cohorts, many modeling-based economic evaluations of cervical screening have been based on unrealistic single birth cohort simulations. The authors examined the effect of a multiple birth cohort simulation on the incremental cost-effectiveness estimates of cervical screening programs, compared to a conventional single cohort simulation. The choice of hypothetical cohort that starts the simulation had a major impact on the cost-effectiveness estimates: Compared with a single birth cohort simulation, the incremental cost-effectiveness of a shift from biennial to triennial screening was 30% higher when using the multiple cohort simulation. Multiple cohort simulations using the different age structures of 4 countries had little impact on the cost effectiveness ratios (variation <5%). Future modeling-based evaluations of screening policies should better reflect the age range of the population that is targeted by carefully specifying the nature of the starting cohort(s).

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Citations

Nov 10, 2011·BMJ : British Medical Journal·Mark JitUNKNOWN Find and Treat Evaluation Team
May 21, 2010·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Carolyn M RutterEric J Feuer
Jan 31, 2012·PharmacoEconomics·Olivier Ethgen, Baudouin Standaert
Oct 27, 2009·Archives of Medical Research·Luz Myriam Reynales-ShigematsuEduardo Lazcano-Ponce
Jul 4, 2007·Cancer·Irene O L WongGabriel M Leung
Jun 15, 2011·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·James F O'MahonyMarjolein van Ballegooijen
Sep 25, 2012·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Uwe SiebertUNKNOWN ISPOR-SMDM Modeling Good Research Practices Task Force
May 25, 2012·Journal of the National Cancer Institute. Monographs·Joseph P MorrisseyJeanne Mandelblatt
Jul 17, 2010·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Karen M KuntzAndrew Briggs
Mar 17, 2010·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Martin Hoyle, Rob Anderson
Sep 1, 2007·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Jonathan KarnonRon Akehurst
Sep 20, 2012·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Uwe SiebertKaren M Kuntz
Aug 29, 2012·Medical Decision Making : an International Journal of the Society for Medical Decision Making·James F O'MahonyMarjolein van Ballegooijen

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