Cancer Council Australia pre-budget submission, 2011-2012

Bowel cancer screening: program expansion would reduce Medicare and PBS costs – and save lives

 
Proposal

• Government to announce a plan for the full implementation of the National Bowel Cancer Screening Program within the 2011-12 federal budget cycle
• The plan to be based on a shift within the next four years from one-off testing to biennial re-screening of eligible individuals
• People turning 60 and 70 to be added to the program from 1 July 2011 as an interim measure for maximum mortality and cost-saving benefit.

Why?

• Australia’s annual bowel cancer bill is set to exceed $1 billion in 2011, with a recent spike in MBS and PBS costs set to sharpen unless cost offsets from screening begin to accrue
• Only 3% of annual bowel cancer expenditure is invested in screening, despite the documented economic and social returns
• Treatment costs would be reduced by early detection through screening with low-cost faecal occult blood test (FOBT)
• FOBT is a cost-effective alternative to MBS-funded colonoscopy as a screening tool
• Continual re-screening is fundamental to any proper screening program
• Adding 60 and 70-year-olds is the best interim investment in lives saved
• A fully implemented program would prevent up to 30 deaths each week
• Implementation plan long overdue; uncertainty of National Bowel Cancer Screening Program’s future a serious concern to independent cancer control sector and jurisdictions.

Estimated investment

• $45 million per annum over the next two financial years – $30m to retain testing of people turning 50, 55 and 65; $15 million to add 60 and 70-year-olds
• Shift to biennial re-screening of participants from 2013-14, incrementally working towards full coverage by 2015-16 at a maximum cost of $140 million per annum thereafter.

Projected offsets

• Substantial reductions in PBS, MBS and public hospital expenditures, estimated in one study to reduce net annual costs of NBCSP over 10-year period to as little as $60 million.
• Overview and detailed rationale follow.