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Health Aff (Millwood). 2012 Apr;31(4):770-9. doi: 10.1377/hlthaff.2011.0814.

An actuarial analysis shows that offering lung cancer screening as an insurance benefit would save lives at relatively low cost.

Author information

1
Milliman, New York City, New York, USA. bruce.pyenson@milliman.com

Abstract

Lung cancer screening is not established as a public health practice, yet the results of a recent large randomized controlled trial showed that screening with low-dose spiral computed tomography reduces lung cancer mortality. Using actuarial models, this study estimated the costs and benefits of annual lung cancer screening offered as a commercial insurance benefit in the high-risk US population ages 50-64. Assuming current commercial reimbursement rates for treatment, we found that screening would cost about $1 per insured member per month in 2012 dollars. The cost per life-year saved would be below $19,000, an amount that compares favorably with screening for cervical, breast, and colorectal cancers. Our results suggest that commercial insurers should consider lung cancer screening of high-risk individuals to be high-value coverage and provide it as a benefit to people who are at least fifty years old and have a smoking history of thirty pack-years or more. We also believe that payers and patients should demand screening from high-quality, low-cost providers, thus helping set an example of efficient system innovation.

PMID:
22492894
DOI:
10.1377/hlthaff.2011.0814
[Indexed for MEDLINE]

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