[Health economics analysis of colorectal screening].
OBJECTIVE
To assess the screening rate, the cost of screening and treatment, and to calculate the expected epidemiological and economic gain and cost-effectiveness of mass-screening programme.


METHODS
The data derive from the financial database of the National Health Insurance Fund of Hungary from 2001. The cost of treatment includes the cost of outpatient care, the acute and chronic inpatient care, the subsidies of medicines' prices and the expenditure on disability to work (including sickness-pay). The expected benefits of the screening programme were modeled with different screening strategy and mortality decrease for a 10 years interval.


RESULTS
The cost of treatment of colorectal cancer was around 9.98 billion Hungarian forints (34 817 250 USD, 38 871 666 EUR) in 2001. In the age-group 45-65 with 10% mortality decline 718 lives (net present value, NPV: 515), with 20% mortality decline 1462 (NPV: 1050) lives can be saved during a 10 years screening programme. The cost of one life saved varies between 4.0 million Hungarian forints (13968 USD, 15595 EUR)/life saved and 16.3 million Hungarian forints (56.952 USD, 63.584 EURO)/life saved according to the mortality decline and screening strategy. The cost of one life year saved varies between 307 909 Hungarian forints (1074 USD, 1200 EUR)/life year saved and 1.25 million Hungarian forints (4381 USD, 4891 EUR)/life years saved.


CONCLUSIONS
The implementation of organized colorectal screening can lead to cost saving in Hungary. The cost-effectiveness of colorectal screening seems to be acceptable for purchaser, but many methodological and organizational issues should be discussed in details.
Boncz
Imre
I
Diagnosztikai és Menedzsment Intézet, Pécsi Tudományegyetem, Egészségügyi Fôiskolai Kar, Pécs, Hungary. boncz.i@oep.hu
Sebestyén
Andor
A
Dózsa
Csaba
C
Pál
Miklós
M
Sándor
János
J
Palásti
Judit
J
Betlehem
József
J
Ember
István
I
D015179:Colorectal Neoplasms / Q000191:economics* / Q000401:mortality / Q000517:prevention & control*; D017046:Cost Savings / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008403:Mass Screening / Q000191:economics* / Q000379:methods; D008875:Middle Aged; D009780:Occult Blood; D019057:Quality-Adjusted Life Years