Cervical Cancer Screening In Thailand: A Model-Based Economic Evaluation
Naiyana Praditsitthikorn*, ***Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, **Bureau of AIDS TB and STIs, Department of Disease Control, Ministry of Public Health
As cervical cancer is the second most common cancer in Thai women, it is important for policy makers to effectively implement the screening program. The aim of this study was to assess the incremental cost-effectiveness of the current 5-yearly screening practice for all women aged 30-60 years, compared with the alternative options that differ in the screening interval and target age groups. The study adopted a Markov model conducted in 2007 under the Thai healthcare setting. All costs were estimated under societal perspective and converted to the year 2012 values using the Thai consumer price index. Utility score was calculated based on the Thai scoring algorithm. We found that screening cervical cancer in Thai women was cost-effective compared to no screening. The current practice showed a certain benefit of 40
percent reduction in incidence and mortality. The second most efficient strategy was a 3-yearly screening for women aged 30-60 years, with the incremental cost-effectiveness ratio -73,300 baht per quality-adjusted life year gained and the expected prevention of 900 cervical cancer cases and 450 deaths per year. Treatment cost was reduced to 1.2 billion baht per year. But more than 180 cytologists and pathologists are needed to cope with increasing demand. Strengthening the current program by increasing the number of women for screening to reach the targeted coverage rate of 80 percent is the most cost-effective and pragmatic option in Thailand.
Download at http://kb.hsri.or.th/dspace/handle/11228/3957?show=full