Table 2. Comparison of key assumptions for several recent cost-effectiveness studies of lung cancer screening.

Component	Black et al. (22) (NLST)	Valenti et al. (1)	Pyenson et al. (23)
Demographic	Medicare	Commercial	Medicare
Age (years)	55–74	50–64	50–74
Stage shift for base case	NLST	I-ELCAP	I-ELCAP
Pack-years	>30	>30	>30
Discount rates for life-years/cost/inflation	3%/3%/0%	0%/0%/0%	0%/0%/0%
Time horizon	Lifetime	Spending to age 65	Lifetime
Cost per LDCT*	$285	$180	$178
Basis for price of LDCT	2009 Medicare	Medicare diagnostic fee [2011] adjusted downward for screening	Medicare fee [2014]
Utilization for screening follow-up	NLST data	I-ELCAP data	I-ELCAP data
Price of care	Repricing NLST data	Actual commercial data	Actual medicare data
Indirect cost	Time and travel	none	none
Base year	2009	2012	2014
Cost per QALY saved	$81,000	$28,240	n/a
Cost per life-year saved	$52,000	n/a	$18,452

*, Medicare has significantly reduced its fee for LDCT in recent years. Table adapted from Curl et al. (24) and expanded. NLST, National Lung Screening Trial; I-ELCAP, International Early Lung Cancer Action Program; LDCT, low dose computed tomography; QALY, quality adjusted life years.