Table 3.
Cost-Effectiveness of Breast Cancer Screening for Strategies Varying by Modality and Start Age: Cost per QALY
| Strategy* | Model G-E | Model W | ||||
|---|---|---|---|---|---|---|
| Discounted costs per 1000 women, $† | Discounted QALYs per 1000 women, QALYs† | ICER, $ per QALY† | Discounted costs per 1000 women, $† | Discounted QALYs per 1000 women, QALYs† | ICER, $ per QALY† | |
| No screening | $13,495,990 | 17378.0 | Baseline comparator | $11,923,450 | 17089.9 | ‡ |
| MRI-35 | $14,516,990 | 17571.4 | $5,290 | $10,716,760 | 17369.9 | Baseline comparator |
| Mammo/MRI-35 | $15,615,310 | 17571.1 | $11,000║ | $11,745,380 | 17421 | $20,130 |
| MRI-30 | $15,928,260 | 17599.3 | $50,580 | $11,822,100 | 17420.6 | $21,800§ |
| Mammo/MRI-30 | $17,494,210 | 17597.7 | $113,200¶ | $13,302,130 | 17482.3 | $25,400 |
| MRI-25 | $18,111,660 | 17607.8 | $256,870 | $13,871,490 | 17438.7 | $120,120** |
| Mammo/MRI-25 | $20,256,890 | 17604.6 | $816,720†† | $15,920,920 | 17504.5 | $117,960 |
G-E, Georgetown-Einstein; ICER, incremental cost-effectiveness ratio; mammo, mammographyMRI, magnetic resonance imaging; QALYs, quality-adjusted life years; W, Wisconsin.
Strategies rank ordered by increasing reduction in breast cancer deaths in Model G-E
Costs and benefits discounted 3% annually.
Strategy was dominated by Mammo/MRI-35, MRI-35 and Mammo/MRI-30 (i.e. more costly and less effective).
Strategy was dominated by Mammo/MRI-35, however because the difference in discounted costs and QALYs between the two strategies are close, the ICER where the reference case is No screening is reported.
Strategy was dominated by Mammo/MRI-35, however because the difference in discounted costs and QALYs between the two strategies are close, the ICER where the reference case is MRI-35 is reported.
Strategy was dominated by MRI-30, however because the differences in discounted costs and QALYS between the two strategies are close, the ICER where the reference case is MRI-35 is reported.
Strategy was dominated by Mammo/MRI-30, however because the difference in discounted costs and QALYs between the two strategies are close, the ICER where the reference case is Mammo/MRI-35 is reported.
Strategy was dominated by MRI-25, however because the differences in discounted costs and QALYs between the two strategies are close, the ICER where the reference case is MRI-30 is reported.