PharmacoEconomics & Outcomes News 804, p30 - 2 Jun 2018
Screening for noncardia gastric
cancer may be cost effective
Endoscopic screening for noncardia gastric
adenocarcinoma (NCGA) appears to be cost effective for
ethnic groups in the US, according to findings of a study
published in Gastroenterology.
A Markov model was used to compare the
cost effectiveness of a no screening (current standard)
for noncardia gastric cancer, or one of two endoscopic
screening stategies at the time of screening colonoscopy
in 50-year-old non-Hispanic Whites, non-Hispanic
Blacks, Hispanics or Asians: upper endoscopy
(esophagogastroduodenoscopy [EGD]) with biopsies
and continued surveillance in patients with intestinal
metaplasia or severe pathology; or EGD with biopsies
every two years. Cost effectiveness was assessed from a
US healthcare perspective over a 30-year time horizon.
The estimated incremental cost effectiveness ratio of
EGD screening with surveillance if indicated, compared
with no screening or biennial screening, was $122 428
per QALY gained in non-Hispanic Whites, $80 278 per
QALY in non-Hispanic Blacks, $76 070 per QALY gained
in Hispanics and $71 451 per QALY gained in Asians.
EGD screening with surveillance if indicated was
therefore cost effective at a willingness-to-pay threshold
of $100 000 per QALY gained in non-Hispanic Blacks,
Hispanics and Asians in the US, but not in non-Hispanic
Whites. No screening was the most cost effective
strategy in non-Hispanic Whites.
"We found that targeted endoscopic screening (and
surveillance if indicated) for NCGA among high-risk
groups according to race and ethnicity might be a
cost effective intervention in the US despite an overall
low background prevalence of disease," said the authors.
* 2015 US dollars
Saumoy M, et al. Cost Effectiveness of Gastric Cancer Screening According to
Race and Ethnicity. Gastroenterology : 17 May 2018. Available from: URL: https:/
PharmacoEconomics & Outcomes News 2 Jun 2018 No. 8041173-5503/18/0804-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved