EP01.03-009 Cost-effectiveness of Lung Cancer Screening in New Zealand Varies by Ethnicity

Abstract

Introduction: In many countries, including New Zealand, lung cancer causes disproportionate health loss to indigenous populations such as Maori. Screening by low dose CT scan (LDCT) has emerged as a promising intervention to reduce lung cancer mortality among high-risk populations but reported incremental cost-effectiveness ratios (ICERs) have varied widely. Furthermore, these analyses rarely examine cost-effectiveness or impacts on health inequalities for indigenous populations. Method(s): A Markov macrosimulation model estimated health-adjusted life-years (HALYs), costs and cost-effectiveness of biennial LDCT screening from ages 55-74 years for Maori and non-Maori male and female current smokers and ex-smokers (within 15 years of quitting) with 30+ pack-years of tobacco exposure, compared with usual care. Input parameters came from literature and NZ-linked health datasets. Where possible parameters were drawn from the findings of the NELSON LDCT screening trial. Scenario analysis tested sensitivity to the model parameters. Result(s): [Formula presented] LDCT screening for lung cancer would be cost-effective in all groups. Cost-effectiveness would be higher in Maori and females compared with non-Maori and males. At a population level LDCT screening in NZ would lead to greater HALY gains for Maori than non-Maori and therefore reduce absolute health inequalities, although Conclusion(s): Cost-effectiveness models for lung cancer screening should obtain ethnic-specific estimates as these can vary substantially and reveal the impact on ethnic health inequalities. Interventions that reduce population health inequalities should be prioritised over those that do not. Keywords: Screening, Cost-effectiveness, EquityCopyright © 2022