TY - JOUR
T1 - Estimation of the costs of cervical cancer screening, diagnosis and treatment in rural Shanxi Province, China
T2 - A micro-costing study
AU - Shi, Ju Fang
AU - Chen, Jun Feng
AU - Canfell, Karen
AU - Feng, Xiang Xian
AU - Ma, Jun Fei
AU - Zhang, Yong Zhen
AU - Zhao, Fang Hui
AU - Li, Rong
AU - Ma, Li
AU - Li, Zhi Fang
AU - Lew, Jie Bin
AU - Ning, Yan
AU - Qiao, You Lin
PY - 2012
Y1 - 2012
N2 - Background: Cost estimation is a central feature of health economic analyses. The aim of this study was to use a micro-costing approach and a societal perspective to estimate aggregated costs associated with cervical cancer screening, diagnosis and treatment in rural China. Methods: We assumed that future screening programs will be organized at a county level (population ~250,000), and related treatments will be performed at county or prefecture hospitals; therefore, this study was conducted in a county and a prefecture hospital in Shanxi during 20089. Direct medical costs were estimated by gathering information on quantities and prices of drugs, supplies, equipment and labour. Direct non-medical costs were estimated via structured patient interviews and expert opinion. Results: Under the base case assumption of a high-volume screening initiative (11,475 women screened annually per county), the aggregated direct medical costs of visual inspection, self-sampled careHPV (Qiagen USA) screening, clinician-sampled careHPV, colposcopy and biopsy were estimated as US$2.64,$7.49,$7.95,$3.90 and $5.76, respectively. Screening costs were robust to screening volume (<5% variation if 2,000 women screened annually), but costs of colposcopy/biopsy tripled at the lower volume. Direct medical costs of Loop Excision, Cold-Knife Conization and Simple and Radical Hysterectomy varied from $61544, depending on the procedure and whether conducted at county or prefecture level. Direct non-medical expenditure varied from $0.68$3.09 for screening/ diagnosis and $83$494 for pre-cancer/cancer treatment. Conclusions: Diagnostic costs were comparable to screening costs for high-volume screening but were greatly increased in lower-volume situations, which is a key consideration for the scale-up phase of new programs. The studys findings will facilitate cost-effectiveness evaluation and budget planning for cervical cancer prevention initiatives in China.
AB - Background: Cost estimation is a central feature of health economic analyses. The aim of this study was to use a micro-costing approach and a societal perspective to estimate aggregated costs associated with cervical cancer screening, diagnosis and treatment in rural China. Methods: We assumed that future screening programs will be organized at a county level (population ~250,000), and related treatments will be performed at county or prefecture hospitals; therefore, this study was conducted in a county and a prefecture hospital in Shanxi during 20089. Direct medical costs were estimated by gathering information on quantities and prices of drugs, supplies, equipment and labour. Direct non-medical costs were estimated via structured patient interviews and expert opinion. Results: Under the base case assumption of a high-volume screening initiative (11,475 women screened annually per county), the aggregated direct medical costs of visual inspection, self-sampled careHPV (Qiagen USA) screening, clinician-sampled careHPV, colposcopy and biopsy were estimated as US$2.64,$7.49,$7.95,$3.90 and $5.76, respectively. Screening costs were robust to screening volume (<5% variation if 2,000 women screened annually), but costs of colposcopy/biopsy tripled at the lower volume. Direct medical costs of Loop Excision, Cold-Knife Conization and Simple and Radical Hysterectomy varied from $61544, depending on the procedure and whether conducted at county or prefecture level. Direct non-medical expenditure varied from $0.68$3.09 for screening/ diagnosis and $83$494 for pre-cancer/cancer treatment. Conclusions: Diagnostic costs were comparable to screening costs for high-volume screening but were greatly increased in lower-volume situations, which is a key consideration for the scale-up phase of new programs. The studys findings will facilitate cost-effectiveness evaluation and budget planning for cervical cancer prevention initiatives in China.
UR - http://www.scopus.com/inward/record.url?scp=84861337688&partnerID=8YFLogxK
U2 - 10.1186/1472-6963-12-123
DO - 10.1186/1472-6963-12-123
M3 - Article
C2 - 22624619
AN - SCOPUS:84861337688
SN - 1472-6963
VL - 12
JO - BMC Health Services Research
JF - BMC Health Services Research
IS - 1
M1 - 123
ER -
