The cost-effectiveness of residential radon remediation programmes: assumptions about benefits stream profiles over time

A recent cost-effectiveness analysis of a residential radon remediation programme considered and highlighted many areas of uncertainty in the parameters chosen for the analysis. One assumption not challenged in the study was the benefits stream profile adopted. There are several different ways of loading the benefits in terms of life years into the cost-effectiveness model and several of these are explored and the results are reported in this study. The benefits profile depends upon the lead-time to cancer manifestation post environmental carcinogen (radon) exposure. The literature reviewed suggests that there are many options for loading benefits to radon-induced lung cancer prevention programmes. In this study, the alternative benefits stream profiles are explored and their implications for the cost-effectiveness ratio are examined. Adopting different benefits stream profiles to the model results in a range of cost-effectiveness ratios from £14 912.90 per life year gained to £52 416.27 per life year gained. The preferred model is reported where the life years gained are assumed to be equally distributed over the last 15 years of the 40-year time horizon of the analysis (Y25–40) and the corresponding cost-effectiveness ratio is £37 943 per life year gained.