# Modelling the health, financial protection and equity impacts of upscaling the ACT NOW early intervention breast cancer pilot program in the Philippines: an extended cost-effectiveness analysis

Source: https://onco.cc/key-papers/paper-chye-act-now-breast-cea-bmjgh-2025/  
OnCo record `paper-chye-act-now-breast-cea-bmjgh-2025` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A model of scaling up ACT NOW, a Philippine pilot that guides women from free breast examination to treatment, found it cost-effective at about 60,700 pesos per disability-adjusted life year saved, preventing 57 breast cancer deaths per 100,000 women over five years.

## Summary

A microsimulation decision-tree model of ACT NOW, with annual clinical breast examination and breast ultrasound for women at high risk (which the paper calls biannual), over five years for healthy women aged 40 to 69. The authors note that the Philippines has reformed financial protection for breast cancer but has no national early detection and treatment programme.

## Fields

- Kind: Key paper
- Last checked: 2026-11-04
- Journal: BMJ Global Health
- Year: 2025
- DOI: 10.1136/bmjgh-2024-016402
- Authors: Chye A, Jan S, Pathy NB, Luna HGC, Lim SB, Kimman M, Woodward M, Peters S, Monaghan H, Ngelangel CA, Angell B
- Findings: Incremental cost-effectiveness ratio of PHP60,711 (USD1,098) per DALY saved, below the 2022 GDP per head of PHP178,751.; Per 100,000 women, 57 deaths and eight financial catastrophes were averted over five years.; Results were sensitive to the share of late-stage cancers after the intervention, treatment adherence, intervention costs and how well it downstaged disease.
- What it means: Early detection with navigation to treatment is likely to be good value in the Philippines, and the authors call for research on the best model for full implementation.
- Caveats: A model, not a trial; its inputs come partly from the pilot.; Five-year horizon.

## Sources

- BMJ Glob Health 2025: https://doi.org/10.1136/bmjgh-2024-016402
- PubMed: https://pubmed.ncbi.nlm.nih.gov/39900428/

## Connected records

- cancers: [Breast cancer (all types)](https://onco.cc/cancers/breast-cancer/)
- institutions: [Health Technology Assessment Council, Philippines](https://onco.cc/institutions/philippine-hta-council/), [Philippine Cancer Society](https://onco.cc/institutions/philippine-cancer-society/), [Philippine Health Insurance Corporation (PhilHealth)](https://onco.cc/institutions/philhealth/)

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