Cost-effectiveness analysis of the oral cancer screening program in Taiwan

Cheng-Chih Huang, Chia Ni Lin, Chia Hua Chung, Jing Shiang Hwang, Sen-Tien Tsai, Jung-Der Wang

Research output: Contribution to journalArticle

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Abstract

Objectives: We assess the incremental cost-effectiveness ratio (ICER) of the oral cancer (OC) screening program in Taiwan. Materials and methods: We interlinked the Cancer Registry, Mortality Registry, National Vital Statistics, reimbursement database of National Health Insurance, and the National Oral Cancer Screening database of Taiwan. A total of 40,092 pathologically verified OC patients were identified and followed during 2002–2014. After stratification by stages, lifetime survival curves were estimated by a rolling extrapolation algorithm to obtain life expectancy (LE), expected years of life lost (EYLL), and lifetime medical costs (LMC). Results: The LE for stages I-IV were 19.5, 14.0, 11.9, and 7.7 life-years, respectively, while those of EYLL were 7.3, 12.2, 15.4, and 18.7 life-years, respectively. The LMC for stages I-IV were US$ 65,752, 60,086, 53,675, and 47,570, respectively. We assumed no life loss for stage 0 with LMC of US$ 5380 spent for the first year after diagnosis. During 2010–2013, 967 out of the 28,018 cases detected with abnormal oral pathology by screening were found to develop OC. The ICER of the screening program was US$ 28,516 per life-year saved, which could be improved to US$ 5579 per life-year saved if all cancers transformed from abnormal oral pathology were detected before stage I. Conclusion: The ICER of the current OC screening program in Taiwan slightly exceeds 1 GDP (gross domestic product) per capita per life-year saved. Intensive follow-up and treatment for all patients with abnormal oral pathology would improve screening efficiency and effectiveness of prevention.

Original languageEnglish
Pages (from-to)59-65
Number of pages7
JournalOral Oncology
Volume89
DOIs
Publication statusPublished - 2019 Feb 1

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Mouth Neoplasms
Taiwan
Early Detection of Cancer
Cost-Benefit Analysis
Oral Pathology
Life Expectancy
Costs and Cost Analysis
Registries
Databases
Gross Domestic Product
Vital Statistics
National Health Programs
Neoplasms
Survival
Mortality

All Science Journal Classification (ASJC) codes

  • Oral Surgery
  • Oncology
  • Cancer Research

Cite this

Huang, Cheng-Chih ; Lin, Chia Ni ; Chung, Chia Hua ; Hwang, Jing Shiang ; Tsai, Sen-Tien ; Wang, Jung-Der. / Cost-effectiveness analysis of the oral cancer screening program in Taiwan. In: Oral Oncology. 2019 ; Vol. 89. pp. 59-65.
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abstract = "Objectives: We assess the incremental cost-effectiveness ratio (ICER) of the oral cancer (OC) screening program in Taiwan. Materials and methods: We interlinked the Cancer Registry, Mortality Registry, National Vital Statistics, reimbursement database of National Health Insurance, and the National Oral Cancer Screening database of Taiwan. A total of 40,092 pathologically verified OC patients were identified and followed during 2002–2014. After stratification by stages, lifetime survival curves were estimated by a rolling extrapolation algorithm to obtain life expectancy (LE), expected years of life lost (EYLL), and lifetime medical costs (LMC). Results: The LE for stages I-IV were 19.5, 14.0, 11.9, and 7.7 life-years, respectively, while those of EYLL were 7.3, 12.2, 15.4, and 18.7 life-years, respectively. The LMC for stages I-IV were US$ 65,752, 60,086, 53,675, and 47,570, respectively. We assumed no life loss for stage 0 with LMC of US$ 5380 spent for the first year after diagnosis. During 2010–2013, 967 out of the 28,018 cases detected with abnormal oral pathology by screening were found to develop OC. The ICER of the screening program was US$ 28,516 per life-year saved, which could be improved to US$ 5579 per life-year saved if all cancers transformed from abnormal oral pathology were detected before stage I. Conclusion: The ICER of the current OC screening program in Taiwan slightly exceeds 1 GDP (gross domestic product) per capita per life-year saved. Intensive follow-up and treatment for all patients with abnormal oral pathology would improve screening efficiency and effectiveness of prevention.",
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Cost-effectiveness analysis of the oral cancer screening program in Taiwan. / Huang, Cheng-Chih; Lin, Chia Ni; Chung, Chia Hua; Hwang, Jing Shiang; Tsai, Sen-Tien; Wang, Jung-Der.

In: Oral Oncology, Vol. 89, 01.02.2019, p. 59-65.

Research output: Contribution to journalArticle

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AB - Objectives: We assess the incremental cost-effectiveness ratio (ICER) of the oral cancer (OC) screening program in Taiwan. Materials and methods: We interlinked the Cancer Registry, Mortality Registry, National Vital Statistics, reimbursement database of National Health Insurance, and the National Oral Cancer Screening database of Taiwan. A total of 40,092 pathologically verified OC patients were identified and followed during 2002–2014. After stratification by stages, lifetime survival curves were estimated by a rolling extrapolation algorithm to obtain life expectancy (LE), expected years of life lost (EYLL), and lifetime medical costs (LMC). Results: The LE for stages I-IV were 19.5, 14.0, 11.9, and 7.7 life-years, respectively, while those of EYLL were 7.3, 12.2, 15.4, and 18.7 life-years, respectively. The LMC for stages I-IV were US$ 65,752, 60,086, 53,675, and 47,570, respectively. We assumed no life loss for stage 0 with LMC of US$ 5380 spent for the first year after diagnosis. During 2010–2013, 967 out of the 28,018 cases detected with abnormal oral pathology by screening were found to develop OC. The ICER of the screening program was US$ 28,516 per life-year saved, which could be improved to US$ 5579 per life-year saved if all cancers transformed from abnormal oral pathology were detected before stage I. Conclusion: The ICER of the current OC screening program in Taiwan slightly exceeds 1 GDP (gross domestic product) per capita per life-year saved. Intensive follow-up and treatment for all patients with abnormal oral pathology would improve screening efficiency and effectiveness of prevention.

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