Producing Economic Evidence to Inform and Improve the Implementation of Cancer Screening Programmes

A criticism of economic evaluations conducted to determine if a new heath intervention is a good use of resources is that they assume that every eligible patient will receive the intervention and it will be delivered in an optimal way. However, many barriers exist in the health system which may reduce the benefits of a new intervention or increase its costs. This means that the cost-effectiveness of an intervention depends on the way it is implemented in practice, and that it may not be cost-effective to implement an intervention unless investment is provided alongside the intervention to address these barriers. This fellowship will explore how implementation barriers can be identified, incorporated into health economic evaluations of interventions in cancer screening, and their impact on costs, outcomes for patients, and cost-effectiveness quantified. Examples of interventions currently under development in cervical screening and risk-stratified breast cancer screening will be used as case studies. The outputs of this research programme will aid decision makers in determining if investments in the health system or further research are required, or will be beneficial, in ensuring that health benefits to patients are maximised while the cost of the intervention is minimised.