ArticlePloS one2014
Budget impact analysis of switching to digital mammography in a population-based breast cancer screening program: a discrete event simulation model.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Cost effectiveness of breast cancer screening and prevention: a systematic review with a focus on risk-adapted strategies.The European journal of health economics : HEPAC : health economics in prevention and care · 2021Pooled it
- Application of discrete event simulation in health care: a systematic review.BMC health services research · 2018Pooled it
- Within-laboratory SARS-CoV-2 real time PCR testing operations in Nepal: a simulation-based analysis.The Lancet regional health. Southeast Asia · 2025Article
- Leveraging quality improvement initiatives to support development of decision support tools in healthcare.Health systems (Basingstoke, England) · 2025Article
- Considerations for Evaluating the Introduction of New Cancer Screening Technology: Use of Interval Cancers to Assess Potential Benefits and Harms.International journal of environmental research and public health · 2022Review
- An exploratory assessment of the impact of a novel risk assessment test on breast cancer clinic waiting times and workflow: a discrete event simulation model.BMC health services research · 2022Article
- Validating a Budget Impact Model Using Payer Insight and Claims Data: A Framework and Case Study.Journal of managed care & specialty pharmacy · 2019Article
- Comparison of Digital and Screen-Film Mammography for Breast-Cancer Screening: A Systematic Review and Meta-Analysis.Journal of breast cancer · 2019Article
- Impact of the Introduction of Digital Mammography in an Organized Screening Program on the Recall and Detection Rate.Journal of digital imaging · 2016Article
- Cost-Effectiveness of Double Reading versus Single Reading of Mammograms in a Breast Cancer Screening Programme.PloS one · 2016Article
- Evaluation of health benefits and harms of the breast cancer screening programme in the Basque Country using discrete event simulation.BMC cancer · 2015Article
- Does digital mammography suppose an advance in early diagnosis? Trends in performance indicators 6 years after digitalization.European radiology · 2015Observational
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Authors and funding
9 authors.
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Abstract
objectiveTo assess the budgetary impact of switching from screen-film mammography to full-field digital mammography in a population-based breast cancer screening program.
methodsA discrete-event simulation model was built to reproduce the breast cancer screening process (biennial mammographic screening of women aged 50 to 69 years) combined with the natural history of breast cancer. The simulation started with 100,000 women and, during a 20-year simulation horizon, new women were dynamically entered according to the aging of the Spanish population. Data on screening were obtained from Spanish breast cancer screening programs. Data on the natural history of breast cancer were based on US data adapted to our population. A budget impact analysis comparing digital with screen-film screening mammography was performed in a sample of 2,000 simulation runs. A sensitivity analysis was performed for crucial screening-related parameters. Distinct scenarios for recall and detection rates were compared.
resultsStatistically significant savings were found for overall costs, treatment costs and the costs of additional tests in the long term. The overall cost saving was 1,115,857€ (95%CI from 932,147 to 1,299,567) in the 10th year and 2,866,124€ (95%CI from 2,492,610 to 3,239,638) in the 20th year, representing 4.5% and 8.1% of the overall cost associated with screen-film mammography. The sensitivity analysis showed net savings in the long term.
conclusionsSwitching to digital mammography in a population-based breast cancer screening program saves long-term budget expense, in addition to providing technical advantages. Our results were consistent across distinct scenarios representing the different results obtained in European breast cancer screening programs.
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