Costs Of Screening Strategies Research Articles

Progress and Challenges in Colorectal Cancer Screening

Although faecal and endoscopic tests appear to be effective in reducing colorectal cancer incidence and mortality, further technological and organizational advances are expected to improve the performance and acceptability of these tests. Several attempts to improve endoscopic technology have been made in order to improve the detection rate of neoplasia, especially in the proximal colon. Based on the latest evidence on the long-term efficacy of screening tests, new strategies including endoscopic and faecal modalities have also been proposed in order to improve participation and the diagnostic yield of programmatic screening. Overall, several factors in terms of both efficacy and costs of screening strategies, including the high cost of biological therapy for advanced colorectal cancer, are likely to affect the cost-effectiveness of CRC screening in the future.

Economic evaluations of pharmacogenetic and genomic screening programs: update of the literature

AbstractPharmacogenetics and pharmacogenomics show great potential for developing individual treatment modalities to achieve optimal therapy effectiveness. Economic analyses are performed to determine whether pharmacogenetic screening strategies provide good value for money. The current review provides an update of published economic studies. Economic analyses of pharmacogenetic screening programs published between 2000 and July 2010 were included in the review. Information was extracted on research area, genetic information, type of economic analysis, key aspects of adherence to economic guidelines, costs and commercial availability of genetic tests, and the role of the funding party. A total of 42 economic studies on pharmacogenetic screening strategies were included. Over time, more cost‐utility analyses were performed, longer time windows were employed, and more extensive sensitivity analyses were conducted. Considerable differences in costs of screening tests for the same polymorphism were found, which often, but not always, had a large influence on the costs of screening strategies. Most studies were conducted from an academic or hospital perspective without direct links to pharmaceutical or diagnostic manufacturers. The quality of economic analyses of pharmacogenetic screening programs has improved over time. However, input variables are not always clearly described. In particular, substantial variation exists in the reported costs of the pharmacogenetic tests. Often these test costs are considered a major cost driver and could therefore be of particular importance for the interpretation of cost‐effectiveness results. Furthermore, the economic studies seem to be conducted to increase awareness of possibilities and perspectives of genetic testing rather than to influence policy decisions on reimbursement. Drug Dev Res 71: 492–501, 2010. © 2010 Wiley‐Liss, Inc.