Comprehensive cost-utility analysis of newborn screening strategies.

نویسندگان

  • Aaron E Carroll
  • Stephen M Downs
چکیده

BACKGROUND Inborn errors of metabolism are a significant cause of morbidity and death among children. Inconsistencies in how individual states arrive at screening strategies, however, lead to marked variations in testing between states. OBJECTIVE To determine the cost-effectiveness of each component test of a multitest newborn screening program, including screening for phenylketonuria, congenital adrenal hyperplasia, congenital hypothyroidism, biotinidase deficiency, maple syrup urine disease, galactosemia, homocystinuria, and medium-chain acyl-CoA dehydrogenase deficiency. METHODS A decision model was used, with cohort studies, government reports, secondary analyses, and other sources. Discounted costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios were measured. RESULTS All except 2 screening tests dominated the "no-test" strategy. The 2 exceptions were screening for congenital adrenal hyperplasia, which cost slightly more than $20,000 per QALY gained, and screening for galactosemia, which cost $94,000 per QALY gained. The screening test with the lowest expected cost was tandem mass spectrometry. The results found in our base-case analysis were stable across variations in nearly all variables. In instances in which changes in risks, sequelae, costs, or utilities did affect our results, the variation from base-case estimates was quite large. CONCLUSIONS Newborn screening seems to be one of the rare health care interventions that is beneficial to patients and, in many cases, cost saving. Over the long term, funding comprehensive newborn screening programs is likely to save money for society.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Data and Methods Used in OTA'S Cost-Effectiveness Analysis of Strategies for Newborn Screening

This appendix presents information on sources of data and methods of calculation used in OTA’s costeffectiveness analysis of strategies for newborn screening, which is presented in chapter 5. That chapter considered seven different strategies offering different combinations of tests for phenylketonuria (PKU), congenital hypothyroidism, galactosemia, maple syrup urine disease (MSUD), and homocys...

متن کامل

I-20: Towards The Transparent Embryo: Dynamics and Ethics of Comprehensive Preimplantation Genetic Screening

Background: To study the ethical aspects of comprehensive preimplantation genetic screening (PGS) through microarrays and whole genome sequencing Materials and Methods: In order to pinpoint ethical issues regarding comprehensive embryo screening we have first investigated the technical and moral issues by organizing a campus meeting with experts and by a literature study. Subsequently we have i...

متن کامل

Cost-Utility Analysis of Screening Strategies for Diabetic Retinopathy in Korea

This study involved a cost-utility analysis of early diagnosis and treatment of diabetic retinopathy depending on the screening strategy used. The four screening strategies evaluated were no screening, opportunistic examination, systematic fundus photography, and systematic examination by an ophthalmologists. Each strategy was evaluated in 10,000 adults aged 40 yr with newly diagnosed diabetes ...

متن کامل

Cost-effectiveness of newborn screening for cystic fibrosis determined with real-life data.

BACKGROUND Previous cost-effectiveness studies using data from the literature showed that newborn screening for cystic fibrosis (NBSCF) is a good economic option with positive health effects and longer survival. METHODS We used primary data to compare cost-effectiveness of four screening strategies for NBSCF, i.e. immunoreactive trypsinogen-testing followed by pancreatitis-associated protein-...

متن کامل

Economic Evaluation of Newborn Hearing Screening Procedures*

In the past few years, there has been a growing interest in the medical literature about the study of the different existing screening procedures to detect hearing impairment in infants and young children. However, concerning their economic evaluation, there are some important aspects, such as indirect costs, which are not considered by that literature. Here, we present an economic evaluation o...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Pediatrics

دوره 117 5 Pt 2  شماره 

صفحات  -

تاریخ انتشار 2006