Cost-Effectiveness Analysis of a Navigation ...
Type de document :
Article dans une revue scientifique
PMID :
URL permanente :
Titre :
Cost-Effectiveness Analysis of a Navigation Program for Colorectal Cancer Screening to Reduce Social Health Inequalities: A French Cluster Randomized Controlled Trial
Auteur(s) :
De Mil, Rémy [Auteur]
Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers [ANTICIPE]
Guillaume, Elodie [Auteur]
Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers [ANTICIPE]
Guittet, Lydia [Auteur]
Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers [ANTICIPE]
Dejardin, Olivier [Auteur]
Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers [ANTICIPE]
Bouvier, Véronique [Auteur]
Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers [ANTICIPE]
Pornet, Carole [Auteur]
Agence Régionale de Santé de Normandie [Caen] [ARS Normandie]
Christophe, Veronique [Auteur]
Laboratoire Sciences Cognitives et Sciences Affectives - UMR 9193 [SCALab]
Notari, Annick [Auteur]
Delattre-Massy, Hélène [Auteur]
Association Dépistage des Maladies dans la Somme [ADEMA 80]
De Seze, Chantal [Auteur]
Association pour le dépistage des cancers dans l'Oise [ADECASO]
Peng, Jérôme [Auteur]
Aisne Preventis [Laon]
launoy, guy [Auteur]
Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers [ANTICIPE]
Berchi, Célia [Auteur]
Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers [ANTICIPE]
Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers [ANTICIPE]
Guillaume, Elodie [Auteur]
Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers [ANTICIPE]
Guittet, Lydia [Auteur]
Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers [ANTICIPE]
Dejardin, Olivier [Auteur]
Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers [ANTICIPE]
Bouvier, Véronique [Auteur]
Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers [ANTICIPE]
Pornet, Carole [Auteur]
Agence Régionale de Santé de Normandie [Caen] [ARS Normandie]
Christophe, Veronique [Auteur]
Laboratoire Sciences Cognitives et Sciences Affectives - UMR 9193 [SCALab]
Notari, Annick [Auteur]
Delattre-Massy, Hélène [Auteur]
Association Dépistage des Maladies dans la Somme [ADEMA 80]
De Seze, Chantal [Auteur]
Association pour le dépistage des cancers dans l'Oise [ADECASO]
Peng, Jérôme [Auteur]
Aisne Preventis [Laon]
launoy, guy [Auteur]
Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers [ANTICIPE]
Berchi, Célia [Auteur]
Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers [ANTICIPE]
Titre de la revue :
Value in Health
Nom court de la revue :
Value in Health
Numéro :
21
Pagination :
p.685-691
Éditeur :
Elsevier BV
Date de publication :
2018-06
ISSN :
1098-3015
Mot(s)-clé(s) en anglais :
colorectal cancer screening
cost-effectiveness analysis
patient navigation
social inequalities
cost-effectiveness analysis
patient navigation
social inequalities
Discipline(s) HAL :
Sciences cognitives
Résumé en anglais : [en]
Background
Patient navigation programs to increase colorectal cancer (CRC) screening adherence have become widespread in recent years, especially among deprived populations.
Objectives
To evaluate the cost-effectiveness ...
Lire la suite >Background Patient navigation programs to increase colorectal cancer (CRC) screening adherence have become widespread in recent years, especially among deprived populations. Objectives To evaluate the cost-effectiveness of the first patient navigation program in France. Methods A total of 16,250 participants were randomized to either the usual screening group (n = 8145) or the navigation group (n = 8105). Navigation consisted of personalized support provided by social workers. A cost-effectiveness analysis of navigation versus usual screening was conducted from the payer perspective in the Picardy region of northern France. We considered nonmedical direct costs in the analysis. Results Navigation was associated with a significant increase of 3.3% (24.4% vs. 21.1%; P = 0.003) in participation. The increase in participation was higher among affluent participants (+4.1%; P = 0.01) than among deprived ones (+2.6%; P = 0.07). The cost per additional individual screened by navigation compared with usual screening (incremental cost-effectiveness ratio) was €1212 globally and €1527 among deprived participants. Results were sensitive to navigator wages and to the intervention effectiveness whose variations had the greatest impact on the incremental cost-effectiveness ratio. Conclusions Patient navigation aiming at increasing CRC screening participation is more efficient among affluent individuals. Nevertheless, when the intervention is implemented for the entire population, social inequalities in CRC screening adherence increase. To reduce social inequalities, patient navigation should therefore be restricted to deprived populations, despite not being the most cost-effective strategy, and accepted to bear a higher extra cost per additional individual screened.Lire moins >
Lire la suite >Background Patient navigation programs to increase colorectal cancer (CRC) screening adherence have become widespread in recent years, especially among deprived populations. Objectives To evaluate the cost-effectiveness of the first patient navigation program in France. Methods A total of 16,250 participants were randomized to either the usual screening group (n = 8145) or the navigation group (n = 8105). Navigation consisted of personalized support provided by social workers. A cost-effectiveness analysis of navigation versus usual screening was conducted from the payer perspective in the Picardy region of northern France. We considered nonmedical direct costs in the analysis. Results Navigation was associated with a significant increase of 3.3% (24.4% vs. 21.1%; P = 0.003) in participation. The increase in participation was higher among affluent participants (+4.1%; P = 0.01) than among deprived ones (+2.6%; P = 0.07). The cost per additional individual screened by navigation compared with usual screening (incremental cost-effectiveness ratio) was €1212 globally and €1527 among deprived participants. Results were sensitive to navigator wages and to the intervention effectiveness whose variations had the greatest impact on the incremental cost-effectiveness ratio. Conclusions Patient navigation aiming at increasing CRC screening participation is more efficient among affluent individuals. Nevertheless, when the intervention is implemented for the entire population, social inequalities in CRC screening adherence increase. To reduce social inequalities, patient navigation should therefore be restricted to deprived populations, despite not being the most cost-effective strategy, and accepted to bear a higher extra cost per additional individual screened.Lire moins >
Langue :
Anglais
Audience :
Internationale
Vulgarisation :
Non
Établissement(s) :
Université de Lille
CNRS
CHU Lille
CNRS
CHU Lille
Équipe(s) de recherche :
Équipe Dynamique Émotionnelle et Pathologies (DEEP)
Date de dépôt :
2024-01-12T15:10:52Z
2024-01-26T09:46:38Z
2024-01-26T09:46:38Z