Title
Cost-effectiveness of newborn screening for cystic fibrosis determined with real-life data
Author
van der Ploeg, C.P.B.
van den Akker-van Marle, M.E.
Vernooij-van Langen, A.M.M.
Elvers, L.H.
Gille, J.J.P.
Verkerk, P.H.
Dankert-Roelse, J.E.
Loeber, J.G.
Triepels, R.H.
van der Pal, S.M.
Dompeling, E.
Pals, G.
Gulmans, V.A.M.
Oey-Spauwen, M.J.W.
Wijnands, Y.H.H.M.
Castricum, L.M.
Arets, H.G.M.
van der Ent, C.K.
Tiddens, H.A.W.M.
de Rijke, Y.B.
Yntema, J.B.
Publication year
2015
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
Subject
Behavioural Changes
CH - Child Health
ELSS - Earth, Life and Social Sciences
Healthy for Life
Health
Healthy Living
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
To reference this document use:
http://resolver.tudelft.nl/uuid:20b608bd-cc36-4a7c-977c-4ba39273d926
DOI
https://doi.org/10.1016/j.jcf.2014.08.007
TNO identifier
516320
Source
Journal of Cystic Fibrosis, 14 (2), 194-202
Document type
article