Background: Breast cancer is the most diagnosed among Indonesian women. We identified the weakness of its early detection, diagnosis and treatment, which must be integrated and organized within healthcare structures. This study explored and developed a decision–analytic model to examine cost-effectiveness analysis of national breast cancer screening strategies in Indonesia.

Methods: Based on the result of systematic review, and exploration among stakeholders, a developed model incorporated the parameter ranges of disease progression, associated costs and health outcomes. Secondary data relevant to model development were collected through multiple sources in Indonesia. A decision-tree approach, combined with a Markov model of breast cancer natural history, aimed to synthesize the evidence of effectiveness and cost, with or without organized screening.

Result: the organized breast cancer screening yielded slightly higher quality-adjusted lifeyears (QALYs) compared to opportunistic breast cancer screening (20.72 versus 20.10 QALYs) but was more expensive relative to the opportunistic strategy (US$ 19,340.44 versus US$ 14,562.94). The discounted incremental cost-effectiveness ratio (ICER) was US$ 7,727.88/QALY below the threshold of three times the Indonesian gross domestic product

(GDP) per capita, US$12 406.

Recommendation: We suggest a community-based early-detection programs when scaled up to a systematic screening program in Indonesia, albeit with limited resources.

My academic and professional journey reflects a deep-seated passion for advancing public health agendas and fostering impactful collaborations within the Indonesian healthcare ecosystem. My doctoral thesis titled "The Effectiveness and Cost-Effectiveness of Screening Strategies for Breast Cancer in Indonesia has demonstrated a comprehensive contextualizing process using a modified analytical framework. I have had the privilege of gaining research experience through active participation in the Knowledge Summaries for Comprehensive Breast Cancer Control along with The National Cancer Centre, Dharmais National Cancer Center. I served as a team member within the Technical Team for Health Technology Assessment Implementation at the Centre of Health Financing and Decentralization Policy, Ministry of Health. Specifically, I joined the team for the Adaptive Health Technology Assessment of Pembrolizumab and Full Health Technology Assessment (HTA) for Bevacizumab Administration in Colorectal Cancer. I am currently engaged in implementation research aimed at evaluating the utilization of teleradiology in Community Health Centers (Puskesmas) and Depression and Cultural Aspects on the Quality of Life of Advanced Stage Cancer Patients in Indonesia.