The opportunity cost (OC) of low adherence with screening (scr) recommendations for colorectal cancer (CRC).

Abstract

1553Background: Scr rates are <60% below the Healthy People 2020 target of 70.5%, leaving 20 million people unscreened. Prior cost effectiveness analyses (CEAs) have shown that although Scr is more costly compared to No Scr, the incremental cost effectiveness ratios (ICERs) for Scr are favorable. However, these CEAs did not include the costs of drugs such as oxaliplatin and bevacizumab. More effective treatments and longer overall survival with advanced CRC result in higher average societal costs of care. Methods: A Markov model was built to represent the CRC incidence and its natural history in the US general population. Individual level simulation was used to compare the benefits of CRC Scr from a societal perspective. Costs and effects were discounted (Dis) at 3%. 12 Scr strategies (ST) were compared to No Scr. Dis Life Years (LY), incidence reduction (IR), CRC mortality reduction (CMR), and Dis costs were measured. ICERs were calculated. Results: Among the STs studied, only stool DNA Scr cost more tha...