Economic evaluation of neonatal screening for phenylketonuria and congenital hypothyroidism
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Published on: June 25, 2010
E A Geelhoed1, B Lewis, D Hounsome
1Population Health Division, Department of Health, Genomics Directorate, Princess Margaret Hospital, Perth, Western Australia. elizabeth.geelhoed@uwa.edu.au
Insights
Neonatal screening for phenylketonuria (PKU) and congenital hypothyroidism (CH) saves A$2.9 million annually. This cost-saving preventive care strategy remains effective despite changes like maternal PKU.
Area of Science:
- Public Health
- Preventive Medicine
- Health Economics
Background:
- Neonatal screening for phenylketonuria (PKU) and congenital hypothyroidism (CH) is a widespread preventive health measure.
- Early detection is crucial as intellectual disability from these conditions is otherwise irreversible.
- Evolving treatment landscapes, including maternal PKU, necessitate ongoing program evaluation.
Purpose of the Study:
- To conduct a cost-benefit analysis of neonatal screening programs for PKU and CH.
- To assess the economic impact of these screening programs in Western Australia.
- To evaluate the influence of maternal PKU on the overall economic outcomes of neonatal screening.
Main Methods:
- Cost analysis based on the existing Western Australian screening program.
- Calculation of averted costs using current and historical patterns of care and intellectual disability.
- Sensitivity analysis to assess the robustness of cost savings under varying assumptions.
Main Results:
- The neonatal screening program yields an annual net saving of A$2.9 million.
- Economic benefits primarily stem from preventing lifelong costs associated with intellectual disability.
- Maternal PKU contributed a minor proportion to the overall program costs.
Conclusions:
- Neonatal screening for PKU and CH represents a cost-effective allocation of healthcare resources.
- The program demonstrates robust economic benefits, remaining cost-saving across various assumptions.
- The emergence of maternal PKU has not significantly altered the positive economic outcomes of neonatal screening.
Objective:
To evaluate the costs and benefits of neonatal screening for phenylketonuria (PKU) and congenital hypothyroidism (CH). Neonatal screening for PKU and CH is common throughout the developed world. It represents a model of preventive care in that the screening procedure is simple and intellectual disability is otherwise irreversible. Changes in treatment and care, and in particular the advent of maternal PKU, require regular evaluation of a programme that also impacts on a large healthy population.
Method:
Costs of screening were based on the programme provided within Western Australia. Costs averted were derived using patterns of care currently adopted in Western Australia and applied according to historical patterns of intellectual disability for each condition.
Results:
A net saving of dollar A2.9 million is attributable to the programme annually. The economic benefits derive from the prevention of intellectual disability which otherwise incurs costs throughout the life of the affected individual. Maternal PKU represented a minor proportion of overall costs. Sensitivity analysis showed that the cost savings were robust, given changes in the levels of intellectual disability, but varied according to the discount rate. The result of a net saving was evident under all assumptions.
Conclusion:
Neonatal screening for PKU and CH is a cost saving use of resources and the emergence of maternal PKU has not had a significant effect on the economic outcomes.
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