Cost- Effectiveness of Mammography Screening Program in a Resource-Limited Post-Soviet Country of Kazakhstan

Document Type: Research Articles

Authors

Nazarbayev University, School of Medicine, Nur-Sultan, Kazakhstan.

Abstract

Objectives: To conduct cost effectiveness and benefit-cost analyses of the organized mammography-screening
program in the Republic of Kazakhstan comparing women who developed breast cancer in screened and unscreened
scenario. Methods: 389,352 screened women were included in the study. Among these, 895 women were further
diagnosed with breast cancer. Outcomes measures include life years saved, quality-adjusted life years, incremental
cost-effectiveness ratio, and value of statistical life year. Sensitivity analyses were performed to assess uncertainty.
Results: Compared to no screening scenario, an organized mammography yielded an additional 1,253 life years and
790 quality-adjusted life years in 2016. The incremental cost-effectiveness ratio was equal to 3,157 USD per one
QALY saved, which is two times less than the GDP per capita in Kazakhstan in 2016. Sensitivity analysis showed that
the mammography remains cost-effective in the majority of the scenarios. Conclusion: Mammography screening in
Kazakhstan was found to be highly cost-effective, associated with treatment cost savings, and can be an efficient use
of limited resources in Kazakhstan.

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