Arrospide, ArantzazuRué, MontserratVan Ravesteyn, Nicolien T.Comas Serrano, MercèSoto-Gordoa, MyriamSarriugarte, GarbiñeMar, Javier2016-06-292016-06-292016Arrospide A, Rue M, van Ravesteyn NT, Comas M, Soto-Gordoa M, Sarriugarte G. et al. Economic evaluation of the breast cancer screening programme in the Basque Country: retrospective cost-effectiveness and budget impact analysis. BMC Cancer. 2016 Jun 1;16(1):344. doi: 10.1186/s12885-016-2386-y1471-2407http://hdl.handle.net/10230/26984BACKGROUND: Breast cancer screening in the Basque Country has shown 20 % reduction of the number of BC deaths and an acceptable overdiagnosis level (4 % of screen detected BC). The aim of this study was to evaluate the breast cancer early detection programme in the Basque Country in terms of retrospective cost-effectiveness and budget impact from 1996 to 2011. METHODS: A discrete event simulation model was built to reproduce the natural history of breast cancer (BC). We estimated for lifetime follow-up the total cost of BC (screening, diagnosis and treatment), as well as quality-adjusted life years (QALY), for women invited to participate in the evaluated programme during the 15-year period in the actual screening scenario and in a hypothetical unscreened scenario. An incremental cost-effectiveness ratio was calculated with the use of aggregated costs. Besides, annual costs were considered for budget impact analysis. Both population level and single-cohort analysis were performed. A probabilistic sensitivity analysis was applied to assess the impact of parameters uncertainty. RESULTS: The actual screening programme involved a cost of 1,127 million euros and provided 6.7 million QALYs over the lifetime of the target population, resulting in a gain of 8,666 QALYs for an additional cost of 36.4 million euros, compared with the unscreened scenario. Thus, the incremental cost-effectiveness ratio was 4,214€/QALY. All the model runs in the probabilistic sensitivity analysis resulted in an incremental cost-effectiveness ratio lower than 10,000€/QALY. The screening programme involved an increase of the annual budget of the Basque Health Service by 5.2 million euros from year 2000 onwards. CONCLUSIONS: The BC screening programme in the Basque Country proved to be cost-effective during the evaluated period and determined an affordable budget impact. These results confirm the epidemiological benefits related to the centralised screening system and support the continuation of the programme.application/pdfeng© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0/nInternational License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and/nreproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to/nthe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver/n(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Mama -- Càncer -- EspanyaCost-eficàciainfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1186/s12885-016-2386-yinfo:eu-repo/semantics/openAccess