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Cost-effectiveness of newborn screening for cystic fibrosis determined with real-life data
| article |
2015
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| Author: |
Ploeg, C.P.B. van der
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Akker-van Marle, M.E. van den
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Vernooij-van Langen, A.M.M.
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Elvers, L.H.
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Gille, J.J.P.
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Verkerk, P.H.
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Dankert-Roelse, J.E.
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Loeber, J.G.
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Triepels, R.H.
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Pal, S.M. van der
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Dompeling, E.
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Pals, G.
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Gulmans, V.A.M.
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Oey-Spauwen, M.J.W.
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Wijnands, Y.H.H.M.
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Castricum, L.M.
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Arets, H.G.M.
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Ent, C.K. van der
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Tiddens, H.A.W.M.
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Rijke, Y.B. de
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Yntema, J.B.
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| Keywords: |
Health · Cystic fibrosis · Newborn screening · Cost-effectiveness · Cost-effectiveness · Newborn screening · Childhood mortality · Controlled study · Cost effectiveness analysis · Cystic fibrosis · Diagnostic test accuracy study · DNA sequence · Early diagnosis · Genetic counseling · Immunoreactive trypsinogen DNA · Immunoreactive trypsinogen DNA sequencing · Immunoreactive trypsinogen pancreatitis associated protein DNA sequencing · Immunoreactive trypsinogen pancreatitis associated protein testing · Major clinical study · Netherlands · Newborn · Newborn disease · Newborn screening · Quality adjusted life year · Sensitivity analysis · Sensitivity and specificity · Sweat test · Healthy for Life · Healthy Living · Behavioural Changes · CH - Child Health · ELSS - Earth, Life and Social Sciences
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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-testing (IRT-PAP), IRT-DNA, IRT-DNA-sequencing, and IRT-PAP-DNA-sequencing, each compared to no-screening. A previously developed decision analysis model for NBSCF was fed with model parameters mainly based on a study evaluating two novel screening strategies among 145,499 newborns in The Netherlands. RESULTS: The four screening strategies had cost-effectiveness ratios varying from €23,600 to €29,200 per life-year gained. IRT-PAP had the most favourable cost-effectiveness ratio. Additional life-years can be gained by IRT-DNA but against higher costs. When treatment costs reduce with 5% due to early diagnosis, screening will lead to financial savings. CONCLUSION: NBSCF is as an economically justifiable public health initiative. Of the four strategies tested IRT-PAP is the most economic and this finding should be included in any decision making model, when considering implementation of newborn screening for CF
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[Abstract]
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