PharmacoEconomics & Outcomes News 792, p20 - 2 Dec 2017 Navigation support not cost effective for CRC screening Patient navigation support by social workers does not appear to be cost effective for increasing adherence to colorectal cancer (CRC) screening in France, according to findings of a study published in Value in Health. In the cluster randomised PRADO study conducted in in northern France between April 2011 and April 2013, 16 250 patients were randomised to the navigation programme for CRC screening, with support by social workers, or to usual screening. The cost effectiveness of the navigation programme was assessed from a payer perspective (French state or French social security system) over the two-year period. Costs of usual screening were not included; direct nonmedical costs of the navigation programme were categorised as navigation costs (for equipment and services) or personnel costs (for navigators and secretarial staff) . The navigation programme significantly increased the overall screening participation rate (24.4% vs 21.1%; p=0.003), but the increase in screening rate was greater in patients with higher socioeconomic status (+4.1%; p=0.01) than in those with low socioeconomic status (+2.6%; p=0.07). The estimated incremental cost-effectiveness ratio for navigation compared with usual screening was €1212 per additional individual screened, overall, €969 per additional individual screened in patients with high socioeconomic status, and €1527 per additional individual screened in patients with low socioeconomic status. The total cost of the navigator intervention over two years was €321 787, with navigator wages accounting for 70% of the cost. "When the intervention is implemented for the entire population, social inequalities in CRC screening adherence increase. To reduce social inequalities, patient navigation should therefore be restricted to deprived populations, despite not being the most cost- effective strategy, and accepted to bear a higher extra cost per additional individual screened," concluded the researchers. * 2013 euros De Mil R, et al. Cost-Effectiveness Analysis of a Navigation Program for Colorectal Cancer Screening to Reduce Social Health Inequalities: A French Cluster Randomized Controlled Trial. Value in Health : 10 Nov 2017. Available from: URL: https://doi.org/10.1016/j.jval.2017.09.020 803286171 1173-5503/17/0792-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 2 Dec 2017 No. 792
PharmacoEconomics & Outcomes News – Springer Journals
Published: Dec 2, 2017
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