Shared learning database
Type and Title of Submission
A cost minimization model of a national roll-out of liquid based cytology in EnglandDescription: Category:
ClinicalDoes the submission relate to the general implementation of all NICE guidance?
YesDoes the submission relate to the implementation of a specific piece of NICE guidance?
NoFull title of NICE guidance:
TA69 - Cervical cancer - cervical screening (review)Category(s) that most closely reflects the nature of the submission:
Description of submission
An optimization model was developed to analyse options for leasing alternative LBC processing machines with different capacities. Variables entered in the model included: the cost of the contract with the supplier, the laboratory labor cost, and inter-laboratory transport costs. All costs referred to the 2005-06 financial year. A simulation program calculated mileages within laboratory networks. Alternative strategies for contracting by laboratories acting independently and by Quality Assessment Regional Centres (QARC) were analyzed.Objectives
To explore the role of laboratory configurations when rolling out the NICE guidance on LBC under a range of 'efficiency' assumptions related to contract.Context
Policy makers increasingly demand evidence of the effectiveness, cost effectiveness and feasibility of potential screening strategies. However, economic analyses designed to assess the cost effectiveness of alternative screening strategies are often based on the assumption that the strategy considered to be acceptable by policy makers would be rolled out nationally without much variation in current practice. However, the actual implementation of a NICE guidance may vary and our goal was to assess whether that results in inefficiencies.Methods
- Centralising the processing of specimens in `hub and spoke' laboratory networks was the least costly strategy. - Total annual costs for England using existing transport links were £14,807,000 for 5-year contracts. - If all laboratories installed processors, the annual cost for 5-year contracts placed by QARCs was £14,941,000 compared with £16,359,000 if the laboratories placed their own contracts. - Three-year contracts averaged an additional £1 million: £15,912,000 for networks and £17,304,000 for independent laboratory contracts.Results and evaluation
This analysis will be published in the September issue of the International Journal of Technology Assessment in Health Care and will soon be available on-line.Key learning points
Deciding on the mode of implementation of a NICE guidance can be challenging for decision makers. These cost minimization appraisal techniques are equally applicable to national screening programmes in general and to other health technologies for which there are significant cost implications associated with innovative policy directives.
|Job Title:||PhD student|
|Organisation:||Health Economics research group|
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This page was last updated: 09 July 2008