Table 2. Cost-effectiveness of navigation for one-time screening colonoscopy: One-way sensitivity analyses.
| Variable | Base case value | Value in sensitivity analysis |
Colonoscopy with Navigation vs. Colonoscopy without Navigation |
||
|---|---|---|---|---|---|
| Incremental cost/person |
Incremental QALYs/10,000 persons |
ICER | |||
| Navigation cost (Completer cost) | $29 | $199 (approximately 7-fold increase) | $0 | 136 | - |
| $300 (approximately 10-fold increase) | $81 | 136 | $6,000 | ||
| $622 (approximately 21-fold increase) | $340 | 136 | $25,000 | ||
| Uptake if navigated | 65% | 43% | $0 | 17 | - |
| 41% | $13 | 5 | $25,200 | ||
| Colonoscopy sensitivity for small polyp/large polyp/CRC | 0.85/0.90/0.95 | 0.75/0.85/0.92 | (-$113) | 130 | Navigation Dominates* |
| Colonoscopy bleeding/perforation rates | 0.0016/0.00085 | 0.008/0.00425 (five-fold increase) | (-$114) | 130 | Navigation Dominates* |
| Colonoscopy cost/with biopsy or polypectomy | $661/$939 | $1,190/$1,690 (80% increase) | $6 | 136 | $446 |
| $1,322/$1,878 (two-fold increase) | $42 | 136 | $3,100 | ||
| $2,644/$3,756 (four-fold increase) | $398 | 136 | $29,300 | ||
| Colonoscopy bleeding/perforation costs | $6,043/$16,377 | $12,086/$32,754 (two-fold increase) | (-$131) | 136 | Navigation Dominates* |
| Colonoscopy cost/with biopsy or polypectomy/bleeding/perforation | $661/$939/$6,043/$16,377 | $992/$1,409/$9,065/$24,566 (50% increase) | (-$45) | 136 | Navigation Dominates* |
| CRC care costs | (40% decrease) | $1 | 136 | $65 | |
| (50% decrease) | $35 | 136 | $2,600 | ||
| (50% increase) | (-$308) | 136 | Navigation Dominates* | ||
*
More effective and less costly than comparator.
CRC, colorectal cancer; QALY, quality-adjusted life-year; ICER, incremental cost-effectiveness ratio.