Evaluation of a Stratified National Breast Screening Program in the United Kingdom: An Early Model-Based Cost-Effectiveness Analysis

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Category: Breast Screening Programs

Tags: Model 13

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Disease Area (Primary)

Breast Screening Programs

Disease Area (Secondary)

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First Developed

05/16/2025

Last Developed

06/30/2025

Software Used

R (e.g., heemod, BCEA, dampack, hesim)

Model Sponsor

Government agency

Intervention

stratified_screening

Model Validation Score

– %

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Results

The base-case analysis, supported by probabilistic sensitivity analysis, suggested that the risk stratified NBSPs (risk 1 and risk-2) were relatively cost-effective when compared with the current UK NBSP, with incremental cost-effectiveness ratios of £16,689 per QALY and £23,924 per QALY, respectively. Stratified NBSP including masking approaches (supplemental screening for women with higher breast density) was not a cost-effective alternative, with incremental cost-effectiveness ratios of £212,947 per QALY (masking) and £75,254 per QALY (risk 1 and masking). When compared with no screening, all stratified NBSPs could be considered cost-effective.

Conclusion

This early model-based CEA presents indicative results that suggest that a risk stratified NBSP is potentially a cost-effective use of health care resources when compared with the current UK NBSP. The proposed model structure will be a key resource as more data become available to support the introduction of stratified NBSP such as the sensitivity and effectiveness of the new screening modalities, the effect of risk communication strategies on NBSP uptake, and the cost of newer treatments for breast cancer.

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Evaluation of a Stratified National Breast Screening Program in the United Kingdom: An Early Model-Based Cost-Effectiveness Analysis

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