Cost-Benefit Analysis of Screening for Gallstone Disease among Chinese Population in Taiwan

Purpose: To explore whether it is worthwhile to launch a routine gallstone disease screening for cholecystectomy prevention among Chinese population from different perspective in Taiwan. Methods: The study cohort was conducted with a total of 2,386 healthy adults voluntarily admitted to a teaching hospital for a physical check-up in 2002 in Taiwan. Annual follow-up screenings of gallstone disease then were until 31 December, 2007. The cost-benefit analysis tool of screening for gallstone disease is based on TreeAge software for medical decision analysis. A decision analysis using the Markov Decision Model was constructed to compare different screening regimes for gallstone disease. Results: In terms of benefit-cost ratio, the different screening programs for gallstone disease could save New Taiwan Dollars (NTD) from 19.61 to 63.41 in discounted costs for each dollar incurred in different screening years from the societal viewpoint for Taiwan and save NTD from 2.89 to 4.71 in different screening years from health care payer's perspective. The average estimate of willingness-to-pay to translate into benefit yields NTD from 807.8 to 4,039 benefits per case due to gallstone disease screening in different screening years during 10-year follow-up. The net present value of the gallstone disease screening were NTD from -133,736 to -217,689.2 in different screening years. Conclusion: It is worthwhile to initial a routine gallstone disease screening of Chinese population for cholecystectomy prevention from the societal perspective but not from consumer decision based on the willingness-to-pay perspective.