Benefit of CTC screening low if reimbursed at same rate as colonoscopy

Computed tomographic colonography (CTC) is not cost-effective compared to currently reimbursed colorectal screening tests, according to a study published in The Journal of the National Cancer Institute (2010 Jul 27. [Epub ahead of print]).

The study, led by Amy Knudsen, PhD, of the Institute for Technology Assessment at Massachusetts General Hospital, looked at whether CTC screening every 5 years could be cost-effective compared to current colorectal screening tests. To calculate the lifetime costs and life expectancy associated with 15 screening strategies, Dr. Knudsen and colleagues used three different simulation models to study an unscreened cohort of Medicare beneficiaries.

Results of the study revealed that the number of life-years gained from 5-yearly CTC were only slightly lower than the number gained from 10-yearly colonoscopy screening. In addition, researchers found that if CTC was reimbursed at $488, which is approximately the same rate as colonoscopy, then lifetime costs associated with CTC screening exceed those of colonoscopy.

“If CTC screening is reimbursed at roughly the same rate as colonoscopy, the cost, relative to the benefit derived and to the availability and costs of other colorectal screening tests, is too high for it to be a cost-effective screening strategy,” concluded the study's authors. “The study also highlights that comparative effectiveness research, and cost-effectiveness analyses in particular, can also be used to inform reimbursement levels.”

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