Aim: For the first time, this article presents a cost-effectiveness comparison of a breast cancer screening programme with a possible health education programme with aspirin for vascular event primary prevention.
Background: Breast cancer screening is a well established part of cancer control programmes yet recent evidence on this intervention has raised questions about harms. Aspirin prophylaxis for the primary prevention of vascular events, such as heart attack, is controversial based on debates about the benefit versus risk balance of the medicine.
Methods: A health economic analysis was undertaken using a cost-effectiveness methodology. The comparison offered a methodological challenge given that breast cancer screening and aspirin prophylaxis are very different interventions. One single end-point of comparison was therefore used, namely number of lives saved. The entire study was set in the context of the country of Wales, given the availability of pertinent previous Welsh research which underpinned some of the key calculations.
Results: The estimated cost per life saved by breast cancer screening was £6,000–£130,000, while for aspirin primary prevention against vascular events, the respective estimation was £50,000–£100,000. These results overlap and suggest the two interventions are comparable in terms of their cost-effectiveness of lives saved.
Conclusions: Based on this analysis, perhaps policy makers might begin to consider the possibility of a health education campaign which clearly presents the benefits and risks of aspirin. As part of this consideration, further studies would appear to be warranted, such as economic and health impact studies on the existing use of aspirin in the community.
aspirin, breast cancer, comparison, cost-effectiveness
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