Cost‑Benefit Analysis of a Population‑Based Prostate‑Specific Antigen Mass Testing for Early Detection of Prostate Cancer in Anambra State, Nigeria: A Health Provider’s Perspective

Abstract

Aims: We conducted a cost‑benefit analysis of a population‑based prostate‑specific antigen (PSA) mass testing for prostate cancer (PCa) from a provider’s perspective to give further insights into the programme’s sustainability at scale‑up. Materials and Methods: A cross‑sectional study design was adopted. The cost and benefit of the population‑based‑specific antigen mass testing were estimated using activity‑based costing and participants’ willingness to pay (WTP), respectively. The study was conducted in a primary health‑care facility in Anambra State, Nigeria. A total of 412 asymptomatic males between 40 and 74 years who had not had a PSA screening within the past five years were recruited for the study. A one‑month population‑based PSA mass screening for PCa was performed at the primary health‑care facility. The cost of population‑based PSA mass testing was presented as cost/male screened while benefit was measured as the participants’ minimum WTP analysis amount. Benefit‑cost ratio (BCR) served as the primary outcome, with values higher than one signifying a self‑sustainable programme. Results: The cost/male screened was USD 13.43 ± 2.26, while the participants’ WTP amount of US$3.99 ± 4.49 to calculate the BCR gave a BCR ratio of 0.3. Conclusion: The estimated BCR showed that the programme would not be sustainable if funding were based solely on participants’ out‑of‑pocket expenses. Other financing mechanisms, such as donor funds, will be necessary to sustain such public health programmes in Nigeria.