Archives of public health = Archives belges de sante publique
Advancing women's health in Egypt: an economic evaluation of the presidential initiative for nationwide breast cancer early detection and treatment
By Abdelghaffar K, Hassany M, Elghazaly H and 16 others.
Abstract
Background
Breast cancer (BC) is the leading cause of cancer-related mortality among women worldwide and poses a major public health and economic challenge in Egypt, where late-stage diagnosis remains high. Egypt launched the Presidential Initiative for Women's Health, a nationwide, publicly funded program providing free early detection, diagnostic, and treatment services. This study presents a model-based economic evaluation of the initiative.
Methods
A hybrid decision tree and Markov model compared the Presidential Initiative pathway with opportunistic case detection, from a societal perspective over a lifetime horizon. Outcomes were quality-adjusted life years (QALYs), life years, net societal cost, and return on investment (ROI); health outcomes were not monetized. Model structure was assessed using face, internal, and cross-validation following the ISPOR-SMDM taxonomy with structured review by 16 clinical and program co-authors. Uncertainty was examined using Monte Carlo probabilistic sensitivity analysis (PSA) with 5000 iterations. Inputs were national program data for July 2019 to September 2024.