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Economics of tandem mass spectrometry screening of neonatal inherited disorders

Published online by Cambridge University Press:  09 August 2006

Abdullah Pandor ,
Joe Eastham ,
James Chilcott ,
Suzy Paisley  and
Catherine Beverley
Abdullah Pandor
Affiliation:
University of Sheffield
Joe Eastham
Affiliation:
University of Leeds
James Chilcott
Affiliation:
University of Sheffield
Suzy Paisley
Affiliation:
University of Sheffield
Catherine Beverley
Affiliation:
University of Sheffield
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Abstract

Objectives: The aim of this study was to evaluate the cost-effectiveness of neonatal screening for phenylketonuria (PKU) and medium-chain acyl-coA dehydrogenase (MCAD) deficiency using tandem mass spectrometry (tandem MS).

Methods: A systematic review of clinical efficacy evidence and cost-effectiveness modeling of screening in newborn infants within a UK National Health Service perspective was performed. Marginal costs, life-years gained, and cost-effectiveness acceptability curves are presented.

Results: Substituting the use of tandem MS for existing technologies for the screening of PKU increases costs with no increase in health outcomes. However, the addition of screening for MCAD deficiency as part of a neonatal screening program for PKU using tandem MS, with an operational range of 50,000 to 60,000 specimens per system per year, would result in a mean incremental cost of −£17,298 (−£129,174, £66,434) for each cohort of 100,000 neonates screened. This cost saving is associated with a mean incremental gain of 57.3 (28.0, 91.4) life-years.

Conclusions: Cost-effectiveness analysis using economic modeling indicates that substituting the use of tandem MS for existing technologies for the screening of PKU alone is not economically justified. However, the addition of screening for MCAD deficiency as part of a neonatal screening program for PKU using tandem MS would be economically attractive.

Keywords

Spectrum analysisMassInfantNewbornNeonatal screeningPhenylketonuriasMetabolismInborn errorsMedium chain acyl co-A dehydrogenase deficiencyCosts and cost analysis
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 22 , Issue 3 , July 2006 , pp. 321 - 326
Copyright
© 2006 Cambridge University Press

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