Health economics evaluation of low-dose spiral CT screening of pulmonary nodules based on Markov model
Objective To evaluate the health economics of low-dose spiral CT(LDCT)screening of pulmonary nod-ules based on Markov model.Methods Based on the LDCT screening data of pulmonary nodules from a Beijing three-A Hospital from 2021 to 2023 and some foreign clinical study data,cost-utility analysis method was adopted to determine the advantageous screening strategy by incremental cost-utility ratio(ICUR).The transition probability parameters were obtained by using R language,and the Markov model was constructed by using TreeAge Pro 2011 software.We assumed that 100 000 people aged 55 and above in China were screened for pulmonary nodules,simulated their disease develop-ment,and evaluated the stability of the model through sensitivity analysis.Results Cost-utility analysis showed that after 20 cycles of the model,the total cost of LDCT screening strategy was 3 543 088 618 yuan,an increase of 784 130 651 yuan compared to the total cost of no screening,and an additional 7 996 quality-adjusted life years(QALYs)were obtained.Each QALY earned costed an additional 98 059.77 yuan.Using WHO health economics evaluation criteria,the ICUR of LDCT screening strategy was greater than 1 time GDP per capita but less than 3 times GDP per capita,which was the domi-nant strategy.Sensitivity analysis showed that no matter how each variable changed within the range of sensitivity analysis,it would not have a great impact on ICUR,and the model had a good stability.Conclusions The ICUR of annual LDCT pulmonary nodule screening in people aged 55 and above is less than 3 times GDP per capita,which has a certain economic effect.And this measure is conducive to the"early detection,early diagnosis,early treatment"of lung cancer.
pulmonary noduleslow-dose spiral CThealth economicsMarkov model
万方数据
维普
