Protocol for the economic evaluation of LCS in Ireland: modelling costs, eligibility, and outcomes.

Background: Lung cancer (LC) is the leading cause of cancer death in Ireland, yet no national screening programme exists. While low-dose computed tomography (LDCT) screening reduces lung cancer mortality by approximately 20% in high-risk populations, its cost-effectiveness in Ireland remains uncertain. Evidence on the economic burden of lung cancer care and the feasibility of screening is needed to support policy decisions.

Aim: This research programme will evaluate the economic impact of lung cancer care in Ireland and assess the cost-effectiveness of LDCT screening. By integrating screening eligibility modelling, stage-specific cost analysis, and economic evaluation, the study aims to generate evidence to support resource allocation and policy development.

Methods: The programme consists of three interlinked work packages. First, screening eligibility will be estimated using a dynamic Markov model that integrates demographic data from the Central Statistics Office (CSO), population projections, and smoking history data from Eurobarometer. Second, a stage-specific cost analysis will be conducted using a discrete event simulation (DES) model informed by data from the National Cancer Registry Ireland (NCRI), the Healthcare Pricing Office (HPO), and other healthcare reimbursement sources. Third, a cost-effectiveness analysis will adapt a UK-based LC natural history model (updated ENaBL model 2022) to evaluate alternative screening strategies, incorporating Irish-specific costs, clinical outcomes, and quality-adjusted life-years (QALYs).

Results and implications: This programme will generate evidence to inform the design of a cost-effective LCS programme in Ireland. Findings will guide healthcare planning, optimise screening strategies, and support sustainable policy decisions.