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Cost-benefit analysis of newborn screening for galactosemia in the Philippines
Carmencita D Padilla1, Leonila F Dans, Sylvia C Estrada
1Department of Pediatrics, Philippine General Hospital, University of the Philippines, Manila, Philippines.
Insights
Newborn screening for galactosemia (GAL) in the Philippines found an incidence of 1 in 106,006. The current screening program
Area of Science:
- Medical Genetics
- Public Health
- Health Economics
Background:
- Galactosemia (GAL) is a rare genetic disorder.
- Early detection and treatment are crucial to prevent severe health complications.
- Newborn screening programs aim to identify infants with GAL shortly after birth.
Purpose of the Study:
- To determine the incidence of galactosemia in the Philippines.
- To evaluate the cost-benefit of newborn screening for GAL from a societal perspective.
Main Methods:
- Cost-benefit analysis was performed.
- Newborn screening utilized the Beutler test after 24 hours of life.
- Incidence rates from the Philippine Newborn Screening Program (PNSP) were used to compare costs and benefits.
Main Results:
- Screening of 157,186 newborns identified 2 cases of galactosemia, yielding an incidence of 1 in 106,006.
- Projected costs for the screening program were $1.1M, with benefits of $0.2M, resulting in a net cost of $0.9M.
- The cost-benefit analysis indicated that program costs outweigh the benefits at the observed incidence rate.
Conclusions:
- The current newborn screening for galactosemia in the Philippines is not cost-beneficial based on the determined incidence.
- Further research into the true incidence of GAL in the Philippine population is needed.
- Adjusting screening strategies or considering a higher incidence rate may improve the program's net benefits.
Abstract:
To determine the incidence of galactosemia (GAL) in the Philippines and to determine whether newborn screening for GAL is cost-beneficial from a societal perspective, cost-benefit analysis was performed. Newborn screening for GAL was done after the 24th hour of life using the Beutler test. Patients screened positive were recalled for confirmatory testing. Using incidence rates obtained from the different participating hospitals of the Philippine Newborn Screening Program (PNSP), the costs for the detection and treatment of GAL were compared to the expected benefits by preventing mental retardation, cataracts and other physical disabilities caused by the disorder that would lead to a loss of productivity for the individual. Sensitivity analyses for incidence and discount rates were also included. Of the 157,186 newborns screened by the PNSP since its inception in 1996, 8 screened positive results. Confirmatory testing of these patients showed that 2 had galactosemia. The incidence of galactosemia in this population therefore, is 1 in 106,006 (95% CI= 1:44,218 - 1:266,796). Projecting the figures to the actual birth rate (1.5M newborns/year), the total costs of the screening program amounted to $1.1M, while the total benefits amounted only to $0.2M, yielding net cost of $0.9M. A cost-benefit analysis of the screening program for galactosemia using the incidence 1 in 106,006 demonstrated that the costs of the program outweigh the benefits. The true incidence of galactosemia in the Philippine population may yield an incidence rate that will result in greater net benefits for the program.
