Table 1.
Model input parameters
| Model parameter | Parameter value | Source |
|---|---|---|
| Analysis population | ||
| Health plan size | 1,000,000 | Assumption; typical health plan size |
| Percentage of health plan members (women) aged 40–75 years | 23.81% | Truven Health Analytics,31 Bonafede et al32 |
| Percentage of women aged 40–75 years who undergo FFDM screening each year | 35.51% | Truven Health Analytics,31 Bonafede et al32 |
| Proportion of patients switched from FFDM to FFDM + DBT screening modality | 100% | Assumption |
| Follow-up services rates | ||
| With diagnostic mammogram or breast ultrasound in the 6 months post-index screen | ||
| FFDM | 15.35% | Truven Health Analytics,31 Bonafede et al32 |
| FFDM + DBT | 10.00% (9.00%–12.00%) | Baseline assumption (range) |
| Cancer detection and staging | ||
| Percentage of patients screened who have breast cancer detected | 0.465% | Truven Health Analytics,31 Bonafede et al32 |
| Stage distribution of cancers detected | ||
| FFDM | Partridge et al,35 American Cancer Society,5 Skaane et al36 | |
| Stage 0 (DCIS/LCIS) | 27.9% | |
| Stage 1 | 32.9% | |
| Stage 2 | 27.8% | |
| Stage 3 | 8.6% | |
| Stage 4 | 2.7% | |
| FFDM + DBT | ||
| Stage 0 (DCIS/LCIS) | 27.9% | |
| Stage 1 | 40.1% | |
| Stage 2 | 22.7% | |
| Stage 3 | 7.0% | |
| Stage 4 | 2.2% | |
| Costs | ||
| Screening costs, per patient (including CAD fee) | ||
| FFDM | $192.50 | Truven Health Analytics,31 Bonafede et al32 |
| FFDB + DBT | $242.50 | Assumption; FFDM cost plus $50 |
| Follow-up services costs in year following diagnosis (per patient) | $1,205.29 | Truven Health Analytics31 |
| One-year, post-diagnosis breast cancer costs by stage | Truven Health Analytics,31 Mittmann et al,37 Legorreta et al,38 Lindfors et al39 | |
| Stage 0 (DCIS/LCIS) | $35,462 | |
| Stage 1 | $43,530 | |
| Stage 2 | $66,472 | |
| Stage 3 | $103,800 | |
| Stage 4 | $223,568 | |
Abbreviations: CAD, computer-aided detection; DBT, digital breast tomosynthesis; DCIS, ductal carcinoma in situ; FFDM, full field digital mammography; LCIS, lobular carcinoma in situ.