C P B van der Ploeg1, M E van den Akker-van Marle2, A M M Vernooij-van Langen3, L H Elvers4, J J P Gille5, P H Verkerk6, J E Dankert-Roelse7. 1. Department of Child Health, TNO, Leiden, The Netherlands. Electronic address: Kitty.vanderPloeg@tno.nl. 2. Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands. 3. Department of Research and Innovation, Atrium Medical Center, Heerlen, The Netherlands; Laboratory for Infectious Diseases and Perinatal Screening, RIVM, Bilthoven, The Netherlands. 4. Laboratory for Infectious Diseases and Perinatal Screening, RIVM, Bilthoven, The Netherlands. 5. Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands. 6. Department of Child Health, TNO, Leiden, The Netherlands. 7. Department of Pediatrics, Atrium Medical Center, Heerlen, The Netherlands.
Abstract
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.
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.
Authors: Maria Fátima Servidoni; Carla Cristina Souza Gomez; Fernando Augusto Lima Marson; Adyléia Aparecida Dalbo Contrera Toro; Maria Ângela Gonçalves de Oliveira Ribeiro; José Dirceu Ribeiro; Antônio Fernando Ribeiro Journal: J Bras Pneumol Date: 2017 Mar-Apr Impact factor: 2.624