Table 4.
Cost-effectiveness and effectiveness of MRI screening vs. annual mammography alone
| Cost-effectiveness* | Mammography only | MRI &mammography | Increment | |||
|---|---|---|---|---|---|---|
| |
Mean |
95% CI |
Mean |
95% CI |
Mean |
95% CI |
| Cost ($) |
5,201 |
3,303-7,911 |
9,893 |
7,459-12,942 |
4,692 |
3,084-6,504 |
| QALYs |
22.57 |
21.86-22.75 |
22.66 |
21.85-22.83 |
0.092 |
−0.027-0.190 |
| C/E ($/QALY) |
231 |
146-351 |
437 |
329-572 |
50,911 |
Dominated-213,794 |
|
Screening effectiveness† |
Mammography only |
MRI &mammography |
|
|||
|
Mean (%) |
95% CI |
Mean (%) |
95% CI |
|
||
| Incidence |
42.7 |
38.8-46.7 |
42.7 |
38.7-46.7 |
|
|
| Program sensitivity‡ |
71.7 |
65.9-77.2 |
93.9 |
89.4-97.3 |
|
|
| Stage distribution | ||||||
| In Situ |
20.8 |
12.8-30.1 |
18.2 |
12.8-24.2 |
|
|
| Local |
48.7 |
39.1-58.3 |
61 |
53.8-67.8 |
|
|
| Regional |
26.9 |
19.6-35.5 |
19.1 |
13.9-25.1 |
|
|
| Distant |
3.6 |
2-7.2 |
1.7 |
0.6-3.8 |
|
|
| Survival | 79.1 | 77.4-80.4 | 80.1 | 78.9-81.1 | ||
Abbreviations: MRI magnetic resonance imaging, QALY quality-adjusted life year.
* Costs and utilities discounted at 3.5% per year.
† Calculated at end of MRI plus mammography screening program (age 65 years).
‡ Proportion of cancers in model detected by screening; all screen-detected cancers (true positives) divided by all incident cancers.