Table 3.
Outcome indicator in cost and consequences in a cohort of 100,000 population among various screening scenarios versus no screening.
| Screening Strategy | Cost (INR) | QALYs | Incremental cost (INR) | Incremental QALYS | ICER (INR per QALYs gained) | Death due to oral cancer | Death averted | Oral cancer incident cases |
|---|---|---|---|---|---|---|---|---|
| No Screening | 213,493,287.27 | 1,777,201.71 | 1180.45 | 5673.59 | ||||
| COE | ||||||||
| 3yr | 325,531,121.20 | 1,783,762.19 | 112,037,833.93 | 6560.48 | 17,077.70 | 728.76 | 451.69 | 3309.91 |
| 3yr HR | 225,651,433.66 | 1,782,840.02 | 12,158,146.39 | 5638.31 | 2156.35 | 768.29 | 412.16 | 3599.55 |
| 5yr | 278,628,112.12 | 1,781,569.17 | 65,134,824.85 | 4367.46 | 14,913.66 | 840.30 | 340.15 | 3923.18 |
| 5yr HR | 202,780,688.58 | 1,781,796.62 | (10,712,598.69) | 4594.91 | −2331.41(D) | 793.64 | 386.81 | 3811.77 |
| 10yr | 252,389,378.34 | 1,780,197.68 | 38,896,091.07 | 2995.97 | 12,982.82 | 954.50 | 225.95 | 4550.84 |
| 10yr HR | 182,794,468.26 | 1,781,457.48 | (30,698,819.01) | 4255.77 | −7213.46(D) | 815.00 | 365.46 | 3984.32 |
| TBS | ||||||||
| 3yr | 405,390,056.25 | 1,783,459.80 | 191,896,768.98 | 6258.09 | 30,663.80 | 749.15 | 431.30 | 3403.39 |
| 3yr HR | 244,711,064.67 | 1,783,104.70 | 31,217,777.40 | 5902.99 | 5288.47 | 764.02 | 416.43 | 3583.81 |
| 5yr | 332,097,814.83 | 1,781,948.80 | 118,604,527.56 | 4747.08 | 24,984.71 | 858.29 | 322.16 | 4009.21 |
| 5yr HR | 223,935,608.11 | 1,781,595.62 | 10,442,320.84 | 4393.91 | 2376.54 | 805.62 | 374.83 | 3865.98 |
| 10yr | 276,596,675.49 | 1,780,469.49 | 63,103,388.22 | 3267.78 | 19,310.79 | 967.70 | 212.75 | 4613.27 |
| 10yr HR | 193,806,328.95 | 1,781,289.71 | (19,686,958.32) | 4088.00 | −4815.80 (D) | 824.56 | 355.89 | 4026.57 |
| OC | ||||||||
| 3yr | 580,751,021.64 | 1,783,881.01 | 367,257,734.37 | 6679.29 | 54,984.51 | 720.70 | 459.76 | 3276.92 |
| 3yr HR | 290,412,200.01 | 1,782,926.02 | 76,918,912.74 | 5724.30 | 13,437.25 | 762.69 | 417.76 | 3573.95 |
| 5yr | 411,105,295.12 | 1,782,321.41 | 197,612,007.85 | 5119.70 | 38,598.36 | 819.81 | 360.64 | 3889.13 |
| 5yr HR | 264,719,039.27 | 1,781,876.29 | 51,225,752.00 | 4674.58 | 10,958.36 | 788.90 | 391.55 | 3790.32 |
| 10yr | 340,632,976.45 | 1,780,753.03 | 127,139,689.18 | 3551.32 | 35,800.69 | 949.23 | 231.22 | 4527.76 |
| 10yr HR | 229,559,511.34 | 1,781,524.49 | 16,066,224.07 | 4322.77 | 3716.65 | 811.18 | 369.28 | 3967.46 |
| LBD | ||||||||
| 3yr | 511,575,807.73 | 1,783,881.01 | 298,082,520.46 | 6679.29 | 44,627.85 | 720.70 | 459.76 | 3271.68 |
| 3yr HR | 268,133,691.67 | 1,782,926.02 | 54,640,404.40 | 5724.30 | 9545.34 | 762.69 | 417.76 | 3573.95 |
| 5yr | 461,969,593.21 | 1,782,321.41 | 248,476,305.94 | 5119.70 | 48,533.38 | 833.18 | 347.28 | 3889.13 |
| 5yr HR | 231,572,958.72 | 1,781,876.29 | 18,079,671.45 | 4674.58 | 3867.66 | 788.90 | 391.55 | 3790.32 |
| 10yr | 312,176,859.58 | 1,780,753.03 | 98,683,572.31 | 3551.32 | 27,787.86 | 949.23 | 231.22 | 4525.92 |
| 10yr HR | 208,845,581.77 | 1,781,524.49 | (4,647,705.50) | 4322.77 | −1075.17(D) | 811.18 | 369.28 | 3967.46 |
Note: HR: High-risk strategy and D: Dominant (The ICER value in negative denotes strategies dominant over no-screening). QAYL: quality-adjusted life years; ICER: incremental cost-effectiveness ratio; COE: conventional oral examination; TBS: toluidine blue staining; OC: oral cytology; LBD: light-based detection.
The significance of bold is to mark the dominant strategies.