MA03.06 Cost Effectiveness of Chest Scan Screeing for Lung Cancer in Abestos Occupational Exposure Subjects: A Model Based Study

Abstract

The National Lung Screening trial (NLST) showed that screening with low-dose computed tomography (CT) compared with chest radiography reduced lung-cancer mortality. There is very few data's on subjects with occupational asbestos exposure. We examined the cost-effectiveness of CT lung cancer screening in a French cohort of asbestos post professional exposure subjects (APEXS cohort). We estimated mean lif-years, costs and incremental cost-effectiveness ration (ICER) for screening with low-dose CT compare to no screening in this population of asbestos exposed subjects. Estimations of life-years gained were based on the efficacy of NLST trial applied to APEXS cohort, adjusted to sex and age. Costs were limited to direct costs, from the payer perspective. We also performed sensitivity analysis based on several assumptions of screening program efficacy. Compared with no screening, screening with low-dose CT, over a period of 2 years, will cost, for 1000 subjects of APEXS cohort 312 645 €, will provide 9.4 additional life-years. The corresponding ICER was 33 102 € per life-gained. Sensitivity analysis showed that this result is sensitive to screening program efficacy (number, stage, and survival diagnosed by the program). ICER of low-dose CT lung cancer program in a cohort of asbestos post occupational exposure population appears as acceptable from the French health system.