Budget Impact Analysis of Cancer Screening: A Methodological Review

Beate Jahn (), Jovan Todorovic (), Marvin Bundo (), Gaby Sroczynski (), Annette Conrads-Frank (), Ursula Rochau (), Gottfried Endel (), Ingrid Wilbacher (), Nikoletta Malbaski (), Niki Popper (), Jagpreet Chhatwal (), Dan Greenberg (), Josephine Mauskopf () and Uwe Siebert ()
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Beate Jahn: UMIT-University for Health Sciences, Medical Informatics and Technology
Jovan Todorovic: UMIT-University for Health Sciences, Medical Informatics and Technology
Marvin Bundo: UMIT-University for Health Sciences, Medical Informatics and Technology
Gaby Sroczynski: UMIT-University for Health Sciences, Medical Informatics and Technology
Annette Conrads-Frank: UMIT-University for Health Sciences, Medical Informatics and Technology
Ursula Rochau: UMIT-University for Health Sciences, Medical Informatics and Technology
Gottfried Endel: Main Association of Austrian Social Insurance Institutions
Ingrid Wilbacher: Main Association of Austrian Social Insurance Institutions
Nikoletta Malbaski: Main Association of Austrian Social Insurance Institutions
Niki Popper: DEXHELPP
Jagpreet Chhatwal: Harvard Medical School
Dan Greenberg: Ben-Gurion University of the Negev
Josephine Mauskopf: RTI Health Solutions, RTI International
Uwe Siebert: UMIT-University for Health Sciences, Medical Informatics and Technology

Applied Health Economics and Health Policy, 2019, vol. 17, issue 4, No 6, 493-511

Abstract: Abstract Background Budget impact analyses (BIAs) describe changes in intervention- and disease-related costs of new technologies. Evidence on the quality of BIAs for cancer screening is lacking. Objectives We systematically reviewed the literature and methods to assess how closely BIA guidelines are followed when BIAs are performed for cancer-screening programs. Data sources Systematic searches were conducted in MEDLINE, EMBASE, EconLit, CRD (Centre for Reviews and Dissemination, University of York), and CEA registry of the Tufts Medical Center. Study eligibility criteria Eligible studies were BIAs evaluating cancer-screening programs published in English, 2010–2018. Synthesis methods Standardized evidence tables were generated to extract and compare study characteristics outlined by the ISPOR BIA Task Force. Results Nineteen studies were identified evaluating screening for breast (5), colorectal (6), cervical (3), lung (1), prostate (3), and skin (1) cancers. Model designs included decision-analytic models (13) and simple cost calculators (6). From all studies, only 53% reported costs for a minimum of 3 years, 58% compared to a mix of screening options, 42% reported model validation, and 37% reported uncertainty analysis for participation rates. The quality of studies appeared to be independent of cancer site. Limitations “Gray” literature was not searched, misinterpretation is possible due to limited information in publications, and focus was on international methodological guidelines rather than regional guidelines. Conclusions Our review highlights considerable variability in the extent to which BIAs evaluating cancer-screening programs followed recommended guidelines. The annual budget impact at least over the next 3–5 years should be estimated. Validation and uncertainty analysis should always be conducted. Continued dissemination efforts of existing best-practice guidelines are necessary to ensure high-quality analyses.

Date: 2019
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DOI: 10.1007/s40258-019-00475-6

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