MPC Member Publications

This database contains a listing of population studies publications written by MPC Members. Anyone can add a publication by an MPC student, faculty, or staff member to this database; new citations will be reviewed and approved by MPC administrators.

Full Citation

Title: Cost-effectiveness of a multitarget stool DNA test for colorectal cancer screening of Medicare beneficiaries

Citation Type: Journal Article

Publication Year: 2019

ISSN: 1932-6203

DOI: 10.1371/JOURNAL.PONE.0220234

Abstract: Background In 2014, the Centers for Medicare and Medicaid Services (CMS) began covering a multitarget stool DNA (mtSDNA) test for colorectal cancer (CRC) screening of Medicare beneficiaries. In this study, we evaluated whether mtSDNA testing is a cost-effective alternative to other CRC screening strategies reimbursed by CMS, and if not, under what conditions it could be. Methods We use three independently-developed microsimulation models to simulate a cohort of previously unscreened US 65-year-olds who are screened with triennial mtSDNA testing, or one of six other reimbursed screening strategies. Main outcome measures are discounted life-years gained (LYG) and lifetime costs (CMS perspective), threshold reimbursement rates, and threshold adherence rates. Outcomes are expressed as the median and range across models. Results Compared to no screening, triennial mtSDNA screening resulted in 82 (range: 79–88) LYG per 1,000 simulated individuals. This was more than for five-yearly sigmoidoscopy (80 (range: 71–89) LYG), but fewer than for every other simulated strategy. At its 2017 reimbursement rate of $512, mtSDNA was the most costly strategy, and even if adherence were 30% higher than with other strategies, it would not be a cost-effective alternative. At a substantially reduced reimbursement rate ($6–18), two models found that triennial mtSDNA testing was an efficient and potentially cost-effective screening option. Conclusions Compared to no screening, triennial mtSDNA screening reduces CRC incidence and mortality at acceptable costs. However, compared to nearly all other CRC screening strategies reimbursed by CMS it is less effective and considerably more costly, making it an inefficient screening option.

Url: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220234

User Submitted?: No

Authors: Naber, Steffie K.; Knudsen, Amy B.; Zauber, Ann G.; Rutter, Carolyn M.; Fischer, Sara E.; Pabiniak, Chester J.; Soto, Brittany; Kuntz, Karen M; Lansdorp-Vogelaar, Iris

Periodical (Full): PLOS ONE

Issue: 9

Volume: 14

Pages: e0220234

Countries:

IPUMS NHGIS NAPP IHIS ATUS Terrapop