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Working paper
Eliminating Cost-Sharing Requirements for Colon Cancer Screening in Medicare
Medicare beneficiaries do not have to pay for screening colonoscopies but must pay coinsurance if a polyp is removed via polypectomy. Likewise, beneficiaries do not have to pay for fecal occult blood tests but are liable for cost-sharing for diagnostic colonoscopies after a positive test. Legislative and regulatory requirements related to colorectal cancer screening are described, and on the basis of Medicare claims, it is estimated that Medicare spending would increase by $48 million annually if Medicare were to waive cost-sharing requirements for these services. The economic impact on Medicare if beneficiaries were not responsible for any cost-sharing requirements related to colorectal cancer screening services is described.
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Economics of Cancer Prevention and Health Promotion in Public Health Programs for Underserved Populations
Providing health services to the public under any government-sponsored program, such as the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), involves an opportunity cost. Public funds devoted to a particular intervention are no longer available to fund other activities. Maximizing the benefit from limited resources requires decision makers to identify the most efficient strategies to provide effective services (e.g., cancer screening) to maximize population health. Such decisions may benefit from collection and analysis of valid, accurate and reliable economic cost and effectiveness data related to program activities. The results may help decision makers identify and select best practices to improve program operations and performance. In this paper, we provide a brief description of the economic evaluation methods used in estimating the costs and benefits of public health programs, and discuss the application of these methods to the NBCCEDP.
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Identifying and controlling for program-level differences in comparative cost analysis: Lessons from the economic evaluation of the National Breast and Cervical Cancer Early Detection Program
In: Evaluation and Program Planning, Band 31, Heft 2, S. 136-144
Identifying and controlling for program-level differences in comparative cost analysis: Lessons from the economic evaluation of the National Breast and Cervical Cancer Early Detection Program
In: Evaluation and program planning: an international journal, Band 31, Heft 2
ISSN: 0149-7189
Estimates of the timing of reductions in genital warts and high grade cervical intraepithelial neoplasia after onset of human papillomavirus (HPV) vaccination in the United States
BACKGROUND: The objective of this study was to estimate the number of years after onset of a quadrivalent HPV vaccination program before notable reductions in genital warts and cervical intraepithelial neoplasia (CIN) will occur in teenagers and young adults in the United States. METHODS: We applied a previously published model of HPV vaccination in the United States and focused on the timing of reductions in genital warts among both sexes and reductions in CIN 2/3 among females. Using different coverage scenarios, the lowest being consistent with current 3-dose coverage in the United States, we estimated the number of years before reductions of 10%, 25%, and 50% would be observed after onset of an HPV vaccination program for ages 12–26 years. RESULTS: The model suggested female-only HPV vaccination in the intermediate coverage scenario will result in a 10% reduction in genital warts within 2–4 years for females aged 15–19 years and a 10% reduction in CIN 2/3 among females aged 20–29 years within 7–11 years. Coverage had a major impact on when reductions would be observed. For example, in the higher coverage scenario a 25% reduction in CIN2/3 would be observed with 8 years compared with 15 years in the lower coverage scenario. CONCLUSIONS: Our model provides estimates of the potential timing and magnitude of the impact of HPV vaccination on genital warts and CIN 2/3 at the population level in the United States. Notable, population-level impacts of HPV vaccination on genital warts and CIN 2/3 can occur within a few years after onset of vaccination, particularly among younger age groups. Our results are generally consistent with early reports of declines in genital warts among youth.
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