Abstract P6-02-09: Bahcesehir mammography screening project (BMSP) is cost-effective in a developing country

Author(s):  
V Ozmen ◽  
N Cabiogsu ◽  
S Ozkan-Gurdal ◽  
N Ozaydin ◽  
A Kayhan ◽  
...  
2021 ◽  
Vol 28 (1) ◽  
pp. e100351
Author(s):  
Victoria Alba Malek Pascha ◽  
Li Sun ◽  
Ramiro Gilardino ◽  
Rosa Legood

ObjectivesArgentina is a low and middle-income country (LMIC) with a highly fragmented healthcare system that conflicts with access to healthcare stated by the country’s Universal Health Coverage plan. A tele-mammography network could improve access to breast cancer screening decreasing its mortality. This research aims to conduct an economic evaluation of the implementation of a tele-mammography program to improve access to healthcare.MethodsA cost-utility analysis was performed to explore the incremental benefit of annual tele-mammography screening for at-risk Argentinian women over 40 years old. A Markov model was developed to simulate annual mammography or tele-mammography screening in two hypothetical population-based cohorts of asymptomatic women. Parameter uncertainty was evaluated through deterministic and probabilistic sensitivity analysis. Model structure uncertainty was also explored to test the robustness of the results.ResultsIt was estimated that 31 out of 100 new cases of breast cancer would be detected by mammography and 39/100 by tele-mammography. The model returned an incremental cost-effectiveness ratio (ICER) of £26 051/quality-adjusted life-year (QALY) which is lower than the WHO-recommended threshold of £26 288/QALY for Argentina. Deterministic sensitivity analysis showed the ICER is most sensitive to the uptake and sensitivity of the screening tests. Probabilistic sensitivity analysis showed tele-mammography is cost-effective in 59% of simulations.DiscussionTele-mammography should be considered for adoption as it could improve access to expertise in underserved areas where adherence to screening protocols is poor. Disaggregated data by province is needed for a better- informed policy decision. Telemedicine could also be beneficial in ensuring the continuity of care when health systems are under stress like in the current COVID-19 pandemic.ConclusionThere is a 59% chance that tele-mammography is cost-effective compared to mammography for at-risk Argentinian women over 40- years old, and should be adopted to improve access to healthcare in underserved areas of the country.


Author(s):  
Amira Masri ◽  
Hanan Hamamy

AbstractThis retrospective study was aiming to determine the cost effectiveness of whole exome sequencing (WES) in the diagnosis of children with developmental delay in a developing country. In this study of 40 patients, the average cost of traditional investigations and indirect costs related to rehabilitation and medications per child were USD847 and 6,585 per year, respectively. With a current cost for WES of approximately USD1,200, we concluded that performing WES could be cost effective, even in countries with limited resources, as it provides the option for genetic counseling in affected families with an ultimate reduction of overall financial burden to both parents and health care system.


2021 ◽  
Vol 27 (4) ◽  
pp. 1-7
Author(s):  
Mariana Y Miyamoto ◽  
Ralph Cohen ◽  
Niro Kasahara

Background/Aims The appropriate roles for alternative diagnostic tests in detecting primary angle closure of the eye are uncertain. This study evaluated the cost-effectiveness of Scheimpflug camera imaging, the van Herick technique and gonioscopy to identify primary angle in a developing country. Methods This cross-sectional diagnostic study included participants aged >40 years with suspected primary angle closure in the developing country of Brazil. All participants underwent Scheimpflug camera imaging, a van Herick test and gonioscopy. The diagnostic ability of these tests was evaluated using a receiver operating characteristic curve. Costs of interventions were derived using the Brazilian Hierarchical Classification of Medical Procedures. The cost-effectiveness of the tests were compared using an incremental cost-effectiveness ratio. Results Gonioscopy was confirmed to be the most accurate diagnostic test for primary angle closure, closely followed by the van Herick test. The accuracy of Scheimpflug camera imaging was considerably lower, largely because of its low sensitivity. The incremental cost-effectiveness ratio demonstrated that Scheimpflug camera imaging was also the least cost-effective, as it was considerably more expensive but with less clinical benefits. Conclusions Because of its relatively low accuracy and high costs, Scheimpflug camera imaging is not as cost-effective as gonioscopy nor the van Herick test as a means of diagnosing primary angle closure in a developing country.


2010 ◽  
Vol 5 (4) ◽  
Author(s):  
V. Guimet ◽  
V. Fournier ◽  
H. Le Goas ◽  
P. Arnaud ◽  
J.M. Audic ◽  
...  

How to select the most cost-effective sustainable option for a sanitation system in the context of an urban or suburban area in a developing country? What expertise is available? Where to begin? In fact, the challenge is not in selecting the right source separation technology or recovery option but in applying it efficiently in the field. The technologies need to be combined with adequate financial and social structures in order to improve sanitary conditions and finally to achieve sustainability and the goal of the sanitation millennium (MDG sanitation target, 7). The article reviews the existing expertise and draws lessons from past experiences in the private sector (management contracts and projects).


2019 ◽  
Vol 43 (spe2) ◽  
pp. 114-132
Author(s):  
Maria Sharmila Alina de Sousa ◽  
Dante Marcello Claramonte Gallian ◽  
Rui Monteiro de Barros Maciel

ABSTRACT As biotechnology innovations move from the bench to the bedside and, recently, also to the Internet, a myriad of emanating challenges and potentials may rise under distinct sociocultural and political economic contexts. Using a grounded-theory-inspired case study focused on the Brazilian research consortium for Medullary Endocrine Neoplasia type 2 (BrasMEN) – an inherited syndrome where genetic tests define cost-effective interventions – we outline facilitators and barriers to both development and implementation of a ‘public health genomics’ strategy under a developing country scenario. The study is based on participant observation at three centres and interviews with all who might hold an interest in MEN2 around Brazil. We discuss how a ‘solidarity’-based motivation for individual and collective ‘biocitizenship’ is driving people’s pre-emptive actions for accessing and making personalised healthcare available at Brazil’s Unified Health System (SUS) via the ‘co-production’ of science, technology and the culture for precision medicine – termed Brazil’s ‘hidden’ biomedical innovation system. Given the establishment of BrasMEN as ‘solidarity networks’ – promoting and supporting the cancer precision medicine’s rationale – our data illustrates how a series of new bioethical challenges raise from such engagement with familial cancer genomics under Brazil’s developing country scenario and how this social/soft technology constitute a solution for Euro/North American societies.


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