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Objective: To analyze the cost-effectiveness of mammography screening for Chinese women. Methods: A model of Markov process adapted with clinical data about breast cancer and population of Chinese women was developed to simulate the progression of breast cancer. The model was running over ten cycles (each cycle represents one year) and then to estimate the total cost/effectiveness of mammography screening by summing across those cycles. Results: For women groups aged between 35-59 years and 35-69 years, ICER (incremental cost-effectiveness ratio) of mammography screening group will be 216 656.00 yuan/QALY (quality adjusted life year) and 248 727.50 yuan/QALY respectively compared with non-screening group, and mammography screening can reduce the mortality of breast cancer by 14.66% and 14.79%, respectively. The ICER is closely correlated with the incidence of breast cancer, sensitivity and specificity of mammography screening and the costs for screening. Conclusion: The result of this analysis indicates that mammography screening in Chinese women can reduce the breast cancer mortality about 15%. According to the incidence rate, mean screening performance (including sensitivity and specificity) and screening costs of breast cancer in Chinese women, the mammography screening is not of cost-effectiveness at present. However, the cost-effectiveness of mammography screening is closely correlated with the incidence rate of breast cancer, screening performance and screening costs, the screening for breast cancer in Chinese women will be of or even good costeffectiveness with the increased incidence of breast cancer, the decreased costs of screening and the improved performance of screening. © 2012 by Tumor.
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PURPOSE: To estimate the cost-effectiveness of treatment with early surgical therapy for primary open-angle glaucoma compared with early medical therapy. METHODS: The hypothetical patient was treated with early surgical or early medical therapy. Relevant costs were obtained from 2002 National Health Insurance data. The success rate of each therapy was obtained from previous reports. Cost-effective Markov model was created using the medical decision analysis program. Markov approach simulated disease progression. Matrix calculation and Monte Carlo simulation were used to determine whether there was a significant difference in quality-of-life adjusted years (QALYs) gained between surgical and medical therapy. RESULTS: In Moorfields study cost-effectiveness for early surgical therapy and medical monotherapy were 110, 161 W/QALYs and 189, 616 W/QALYs, respectively. In the Collaborative Initial Glaucoma Treatment Study (CIGTS) cost-effectiveness for early surgical therapy and medical monotherapy were 153, 578 W/QALYs and 201, 353 W/QALYs, respectively. Matrix calculation and Monte Carlo simulation showed that early surgical therapy was superior cost-effective treatment to medical therapy. CONCLUSIONS: By cost-effective Markov medical decision model, early surgical therapy for primary open-angle glaucoma is a cost-effective treatment option and is superior to medical therapy.