Health economic issues of screening programmes.

Economic evaluation supports decision making in health care in view of alternative courses of action and limited resources. It aims at providing maximum benefit in relation to invested resources. In the context of screening, it is required from an economical viewpoint that the cost of case finding, including confirmatory diagnostic tests and treatment, should be economically balanced in relation to possible expenditure on medical care as a whole. Costs of false-positive findings are crucial in newborn screening and pertain to direct costs (e.g. necessary diagnostic work-up), indirect costs (e.g. absence from work of parents) and intangible costs (e.g. anxiety and distress caused, stigmatisation).