Economic Impact of a Structured Early Breast Cancer Detection Initiative in the Brazilian Private Health Sector

OBJECTIVES: To evaluate the clinical and economic impact of a structured breast cancer early detection initiative incorporating active recall and nurse navigation within a private healthcare cooperative in Brazil's supplemental health sector. METHODS: A 2-year initiative was implemented across a cooperative serving 140 000 beneficiaries. Active recall and nurse navigation were combined to improve screening adherence. Real-world administrative claims data captured direct medical costs across the continuum of care. A Markov state-transition model compared costs and outcomes between the early detection scenario and a metastatic counterfactual. A complementary cost-only analysis expressed outcomes in monetary terms. RESULTS: Over 2 years, 1999 mammograms increased screening coverage from 52% to 66%, generating appropriate downstream procedures and identifying 2 breast cancer cases. Total expenditures for screening and early-stage treatment reached R$702 485.00. The HER2-positive case identified was estimated to have incurred R$1 653 704.00 in metastatic treatment costs without early detection. Avoided expenditures resulted in net savings of R$951 219.00 and a 135% return on investment. The early detection strategy demonstrated economic dominance, with lower costs and greater expected health benefit. CONCLUSIONS: A coordinated model combining active recall and nurse navigation demonstrated feasibility, scalability, and meaningful clinical and economic value in a fragmented care environment. Early detection represents a strategically dominant intervention for improving oncological outcomes and enhancing financial sustainability in Brazil's supplemental health sector and similar hybrid systems.