A BUDGET IMPACT MODEL FOR A PROGRAM TO INCREASE COLORECTAL CANCER SCREENING
Candidate for the Lee B. Lusted Student Prize Competition
Method: A Markov model of CRC natural history was developed with TreeAge software to evaluate the intervention in a hypothetical 200,000 US female population in the United States. A 5-year time frame with all payer health care organization perspective was used for model illustration. The model incorporates the natural history of the disease based on epidemiological data from the literature. The population age distribution was based on the 2012 U.S. Census. Example cost data were obtained from published cost studies of colorectal cancer and screening promotion. All costs were undiscounted and adjusted to 2013 U.S. dollars by the medical care component of the consumer price index. An alternative simplified Markov model was developed to compare the results with the natural history based model.
Result: The budget impact model generates estimates of the number of CRC cases prevented, the total additional costs including those associated with the intervention, diagnosis, and cancer treatment and the cost per person in the target population. In our simulation, the total cost per person was $276 annually with usual care screening program vs. $306 annually with the intervention program. Annual cost per capita using a simplified Markov model was $131 and $185 for the usual care screening and intervention programs, respectively.
Conclusion: Budget impact models were designed to allow program decision-makers to insert their own cost and population parameters to generate projections of cases and costs over 3 to 5years. Model simplicity is a valued feature, but may result in inaccurate projections. Our simulations suggest that in the case of colorectal cancer screening promotion, the simple model may substantially underestimate the budget impact.
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