Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jan 12:7:53-63.
doi: 10.2147/CEOR.S76167. eCollection 2015.

Value analysis of digital breast tomosynthesis for breast cancer screening in a commercially-insured US population

Machaon M Bonafede  1 , Vivek B Kalra  2 , Jeffrey D Miller  1 , Laurie L Fajardo  3
Affiliations

Value analysis of digital breast tomosynthesis for breast cancer screening in a commercially-insured US population

Machaon M Bonafede et al. Clinicoecon Outcomes Res. .

Abstract

Purpose: The objective of this study was to conduct a value analysis of digital breast tomosynthesis (DBT) for breast cancer screening among women enrolled in US commercial health insurance plans to assess the potential budget impact associated with the clinical benefits of DBT.

Methods: An economic model was developed to estimate the system-wide financial impact of DBT as a breast cancer screening modality within a hypothetical US managed care plan with one million members. Two scenarios were considered for women in the health plan who undergo annual screening mammography, ie, full field digital mammography (FFDM) and combined FFDM + DBT. The model focused on two main drivers of DBT value, ie, the capacity for DBT to reduce the number of women recalled for additional follow-up imaging and diagnostic services and the capacity of DBT to facilitate earlier diagnosis of cancer at less invasive stages where treatment costs are lower. Model inputs were derived from published sources and from analyses of the Truven Health MarketScan(®) Research Databases (2010-2012). Comparative clinical and economic outcomes were simulated for one year following screening and compared on an incremental basis.

Results: Base-case analysis results show that 4,523 women in the hypothetical million member health plan who are screened using DBT avoid the use of follow-up services. The overall benefit of DBT was calculated at $78.53 per woman screened. Adjusting for a hypothetical $50 incremental cost of the DBT examination, this translates to $28.53 savings per woman screened, or $0.20 savings per member per month across the plan population and an overall cost savings to the plan of $2.4 million per year.

Conclusion: The results of this study demonstrate clinical and economic favorability of DBT for breast cancer screening among commercially-insured US women. Wider adoption of DBT mammography presents an opportunity to deliver value-based care in the US health care system.

Keywords: breast cancer screening; cost analysis; digital breast tomosynthesis; economic model; mammography; value analysis.

PubMed Disclaimer

References

    1. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin. 2014;64(1):9–29. - PubMed
    1. Howlader N, Noone AM, Krapcho M, et al., editors. SEER Cancer Statistics Review, 1975–2011. Bethesda, MD, USA: National Cancer Institute; 2014. [Accessed November 17, 2014]. Available from: http://seer.cancer.gov/csr/1975_2011/
    1. Smith RA, Manassaram-Baptiste D, Brooks D, et al. Cancer screening in the United States, 2014: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin. 2014;64(1):30–51. - PubMed
    1. Berry DA, Cronin KA, Plevritis SK, et al. Cancer Intervention and Surveillance Modeling Network Collaborators Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med. 2005;353(17):1784–1792. - PubMed
    1. American Cancer Society . Breast Cancer Facts and Figures 2012. Atlanta, GA, USA: American Cancer Society Inc; 2012. [Accessed October 16, 2014]. Available from: http://www.cancer.org/research/cancerfactsfigures/cancerfactsfigures/can....