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Volume 9
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10.1080/20016689.2021.1948670
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Journal of Market Access & Health Policy (JMAHP) is published by MDPI from Volume 12 Issue 1 (2024). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Taylor & Francis.
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Article

The Impact of Increasing Multitarget Stool DNA Use among Colorectal Cancer Screeners in a Self-Insured US Employer Population

by
Joanne M Hathway
1,
Lesley-Ann Miller-Wilson
2,*,
Abhishek Sharma
1,3,
Ivar S Jensen
1,
Weiyu Yao
1,
Sajjad Raza
1,
Philip D Parks
2 and
Milton C Weinstein
4
1
PRECISIONheor, Precision Value & Health, Boston, MA, USA
2
Exact Sciences Corporation, Madison, WI, USA
3
Department of Global Health, Boston University School of Public Health, Boston, MA, USA
4
Harvard T. H. Chan School of Public Health, Boston, MA, USA
*
Author to whom correspondence should be addressed.
J. Mark. Access Health Policy 2021, 9(1), 1948670; https://doi.org/10.1080/20016689.2021.1948670
Submission received: 13 October 2020 / Revised: 4 June 2021 / Accepted: 22 June 2021 / Published: 1 September 2021

Abstract

Background: In the United States (US), colorectal cancer (CRC) is the second leading cause of cancer-related deaths. With the majority of the US population covered by employer-based health plans, employers can play a critical role in increasing CRC screening adherence, which may help avert CRC-related deaths. Therefore, it is important for self-insured employers to consider the impact of appropriate utilization of CRC screening options. Objective: To evaluate the impact of increasing multitarget stool DNA [mt-sDNA (Cologuard®)] use among CRC screeners from the perspective of a US self-insured employer. Methods: A 5-year Markov model was developed to quantify the budget impact of increasing mt-sDNA from 6% to 15% among average-risk screeners using colonoscopy, fecal immunological test, and mt-sDNA. Data on direct medical costs were obtained from published literature, Medicare CPT codes, and the Healthcare cost and Utilization project. Indirect costs included productivity loss due to workplace absenteeism for CRC screening and treatment. Results: With a hypothetical population of 100,000 employees with screeners aged 50–64 years, compared to status quo, increased mt-sDNA utilization resulted in no differences in the numbers of cancers detected and the overall direct and indirect cost savings were ~$214,000 ($0.04 per-employee-per-month) over 5 years. Most of the savings were due to a reduction in the direct medical expenditure related to CRC screening, adverse events, and productivity loss due to colonoscopy screening. Similar results were observed in the model simulation among screeners aged 45–64 years. Conclusion: Increased utilization of mt-sDNA for CRC screening averts direct and indirect medical costs from a self-insured US employer perspective.
Keywords: colorectal cancer; screening; employer-based insurance; budget impact colorectal cancer; screening; employer-based insurance; budget impact

Share and Cite

MDPI and ACS Style

Hathway, J.M.; Miller-Wilson, L.-A.; Sharma, A.; Jensen, I.S.; Yao, W.; Raza, S.; Parks, P.D.; Weinstein, M.C. The Impact of Increasing Multitarget Stool DNA Use among Colorectal Cancer Screeners in a Self-Insured US Employer Population. J. Mark. Access Health Policy 2021, 9, 1948670. https://doi.org/10.1080/20016689.2021.1948670

AMA Style

Hathway JM, Miller-Wilson L-A, Sharma A, Jensen IS, Yao W, Raza S, Parks PD, Weinstein MC. The Impact of Increasing Multitarget Stool DNA Use among Colorectal Cancer Screeners in a Self-Insured US Employer Population. Journal of Market Access & Health Policy. 2021; 9(1):1948670. https://doi.org/10.1080/20016689.2021.1948670

Chicago/Turabian Style

Hathway, Joanne M, Lesley-Ann Miller-Wilson, Abhishek Sharma, Ivar S Jensen, Weiyu Yao, Sajjad Raza, Philip D Parks, and Milton C Weinstein. 2021. "The Impact of Increasing Multitarget Stool DNA Use among Colorectal Cancer Screeners in a Self-Insured US Employer Population" Journal of Market Access & Health Policy 9, no. 1: 1948670. https://doi.org/10.1080/20016689.2021.1948670

APA Style

Hathway, J. M., Miller-Wilson, L. -A., Sharma, A., Jensen, I. S., Yao, W., Raza, S., Parks, P. D., & Weinstein, M. C. (2021). The Impact of Increasing Multitarget Stool DNA Use among Colorectal Cancer Screeners in a Self-Insured US Employer Population. Journal of Market Access & Health Policy, 9(1), 1948670. https://doi.org/10.1080/20016689.2021.1948670

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