Presentation Authors: Miki Haifler, Guy Verhovsky*, Yishai Hode Rappaport, Tzriffin, Israel, Michael Leshno, Tel-Aviv, Israel, Amnon Zisman, Shmuel Roizman, Tzriffin, Israel
Introduction: In the last 2 decades, the rate of metastatic Renal Cell Carcinoma (RCC) at diagnosis declined from 33% to 17%. This fact is attributed to massive penetration of imaging tests leading to a marked stage migration. The cost of targeted therapy for metastatic RCC patients is very high. These trends led us to hypothesize that screening for RCC with ultrasound may be cost effective. Objective:To assess the cost effectiveness of screening with ultrasound(us) for renal tumors in the general population over 60 years of age.
Methods: Using the Markov model, a mathematical framework was set up describing the course of disease with and without screening for RCC. Quality Adjusted Life Year (QALY) and financial costs were the outputs of the model.
Results: Average costs for the screening strategy was 137.4 U$ and for non-screening was 31.4 USD. Screening and non-screening strategy would add an average of 21.7396 and 21.7385 QALY, respectively. An increase of 0.001 QALY equates to Incremental Cost Effectiveness Ratio (ICER) of 86,4 USD , the cost which is considered cost effective for 1 QALY point is approximately 27,548.21 U$. The two variables most influential on the model output were prevalence of RCC and US cost.
Conclusions: To our knowledge, this is the sole cost benefit screening study performed for RCC in the targeted therapy era. Screening for renal tumors using abdominal ultrasonography at a cost of 35.81 USD per exam is cost effective.