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Conference Paper: The influence of incremental cost-effectiveness ratio on Health Technology Assessment of Cancer Screening in Hong Kong

TitleThe influence of incremental cost-effectiveness ratio on Health Technology Assessment of Cancer Screening in Hong Kong
Authors
Issue Date2016
PublisherSage Science Press (US). The Journal's web site is located at http://www.sagepub.com/journal.aspx?pid=263
Citation
The 16th Biennial European Conference of the Society for Medical Decision Making (SMDM-European Conference 2016), London, UK., 12-16 June 2016. In Medical Decision Making, 2016, v. 36 n. 7, p. E509-E510 How to Cite?
AbstractPURPOSE: Developed countries set their own ICER threshold to reflect how much they value for the gain in health of their populations. An ICER threshold approach for policy decision making is common in developed countries but Research on the appropriate ICER threshold for positive decision in Hong Kong is lacking. This study was to critically review the literature on cost-effectiveness of cancer screening interventions, and examine incremental cost-effectiveness ratios (ICER) that may influence government recommendation on cancer screening strategies, and funding for mass implementation in Hong Kong health care system. METHOD(s): We conducted a literature review of cost-effectiveness studies on Hong Kong population related to cancer screening published up to 2015, through hand search and database search of Pubmed, Web of Science, Embase, and OVID Medline. Methodological quality of selected studies was assessed using Consolidated Health Economic Evaluation Reporting Standards checklist. Binary data on government’s decisions were obtained from advisory body. Mixed-effect logistic regression analysis was used to examine the impact of ICER on decision. Using Youden’s index, an optimal ICER threshold value for positive decision was examined by area under receiver operating characteristic curve (AUC). RESULT(s): Eight studies reporting 30 cost-effectiveness pairwise comparisons of population-based cancer screening for colorectal (n=16), cervical (n=9), breast (n=4) and gastric cancer (n=1) were identified. Most studies established a Markov modeling (88.9%), from perspective of healthcare provider (77.8%), and reported an incremental cost-effectiveness ratio (ICER) of a cancer screening strategy versus comparator as outcomes in terms of cost per life-years (55.6%), or cost per quality-adjusted life-years (55.6%). Among comparisons with a mean ICER of USD 102,931 (range: 800-715,137), the decrease in ICER value by 1,000 was associated with increase odds (odds ratios: 0.990, 0.981-0.999; P=0.033) of positive recommendation. An optimal ICER value of USD 61,600 per effectiveness unit yielded high sensitivity of 90% and specificity of 85%. No association between ICER value and funding decision was observed. CONCLUSION(s): Linking published evidence to Government recommendations and practice on cancer screening, ICER influences the decision on the adoption of health technology in Hong Kong. Potential ICER threshold in Hong Kong may be higher than those of developed countries.
DescriptionPoster Session 3: no. PS3-19
Persistent Identifierhttp://hdl.handle.net/10722/233622
ISSN
2015 Impact Factor: 2.908
2015 SCImago Journal Rankings: 1.864

 

DC FieldValueLanguage
dc.contributor.authorWong, CKH-
dc.contributor.authorLang, HHB-
dc.contributor.authorGuo, Y-
dc.contributor.authorLam, CLK-
dc.date.accessioned2016-09-20T05:38:02Z-
dc.date.available2016-09-20T05:38:02Z-
dc.date.issued2016-
dc.identifier.citationThe 16th Biennial European Conference of the Society for Medical Decision Making (SMDM-European Conference 2016), London, UK., 12-16 June 2016. In Medical Decision Making, 2016, v. 36 n. 7, p. E509-E510-
dc.identifier.issn0272-989X-
dc.identifier.urihttp://hdl.handle.net/10722/233622-
dc.descriptionPoster Session 3: no. PS3-19-
dc.description.abstractPURPOSE: Developed countries set their own ICER threshold to reflect how much they value for the gain in health of their populations. An ICER threshold approach for policy decision making is common in developed countries but Research on the appropriate ICER threshold for positive decision in Hong Kong is lacking. This study was to critically review the literature on cost-effectiveness of cancer screening interventions, and examine incremental cost-effectiveness ratios (ICER) that may influence government recommendation on cancer screening strategies, and funding for mass implementation in Hong Kong health care system. METHOD(s): We conducted a literature review of cost-effectiveness studies on Hong Kong population related to cancer screening published up to 2015, through hand search and database search of Pubmed, Web of Science, Embase, and OVID Medline. Methodological quality of selected studies was assessed using Consolidated Health Economic Evaluation Reporting Standards checklist. Binary data on government’s decisions were obtained from advisory body. Mixed-effect logistic regression analysis was used to examine the impact of ICER on decision. Using Youden’s index, an optimal ICER threshold value for positive decision was examined by area under receiver operating characteristic curve (AUC). RESULT(s): Eight studies reporting 30 cost-effectiveness pairwise comparisons of population-based cancer screening for colorectal (n=16), cervical (n=9), breast (n=4) and gastric cancer (n=1) were identified. Most studies established a Markov modeling (88.9%), from perspective of healthcare provider (77.8%), and reported an incremental cost-effectiveness ratio (ICER) of a cancer screening strategy versus comparator as outcomes in terms of cost per life-years (55.6%), or cost per quality-adjusted life-years (55.6%). Among comparisons with a mean ICER of USD 102,931 (range: 800-715,137), the decrease in ICER value by 1,000 was associated with increase odds (odds ratios: 0.990, 0.981-0.999; P=0.033) of positive recommendation. An optimal ICER value of USD 61,600 per effectiveness unit yielded high sensitivity of 90% and specificity of 85%. No association between ICER value and funding decision was observed. CONCLUSION(s): Linking published evidence to Government recommendations and practice on cancer screening, ICER influences the decision on the adoption of health technology in Hong Kong. Potential ICER threshold in Hong Kong may be higher than those of developed countries.-
dc.languageeng-
dc.publisherSage Science Press (US). The Journal's web site is located at http://www.sagepub.com/journal.aspx?pid=263-
dc.relation.ispartofMedical Decision Making-
dc.rightsMedical Decision Making. Copyright © Sage Science Press (US).-
dc.titleThe influence of incremental cost-effectiveness ratio on Health Technology Assessment of Cancer Screening in Hong Kong-
dc.typeConference_Paper-
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.emailLang, HHB: blang@hkucc.hku.hk-
dc.identifier.emailGuo, Y: viviguo@hku.hk-
dc.identifier.emailLam, CLK: clklam@hku.hk-
dc.identifier.authorityWong, CKH=rp01931-
dc.identifier.authorityLang, HHB=rp01828-
dc.identifier.authorityLam, CLK=rp00350-
dc.identifier.doi10.1177/0272989X16665121-
dc.identifier.hkuros266413-
dc.identifier.volume36-
dc.identifier.issue7-
dc.identifier.spageE509-
dc.identifier.epageE510-
dc.publisher.placeUnited States-

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