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Cost-benefit analysis of G6PD screening in Lebanese newborn males
Issam Khneisser1, Salim M Adib, Jacques Loiselet
1Newborn Screening Laboratory, Medical Genetic Unit, Faculty of Medicine, Saint Joseph University, B.P. 11-5076 Riad El Solh, Beirut, Lebanon. issam.khneisser@usj.edu.lb
Insights
Systematic newborn screening for Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency in Lebanon is highly cost-effective. Early detection significantly reduces severe anemia crises and hospitalizations, lowering overall healthcare costs compared to managing the condition without screening.
Area of Science:
- Medical Genetics
- Public Health
- Health Economics
Background:
- Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency is a prevalent genetic disorder in Lebanon, affecting 1% of males.
- Established screening methods allow for early detection in newborns.
Purpose of the Study:
- To evaluate the cost-effectiveness of universal G6PD deficiency screening for all male newborns in Lebanon.
- To compare healthcare costs associated with screened versus unscreened G6PD-deficient individuals.
Main Methods:
- A retrospective survey of 139 G6PD-deficient babies identified between 1999 and 2004 was conducted.
- Data on acute anemia crises and hospitalizations were collected and compared to historical community data.
Main Results:
- Screened G6PD-deficient infants experienced a 95% reduction in severe acute anemia crises requiring hospitalization compared to unscreened individuals.
- The cost of screening (3 USD) is substantially lower than the estimated hospitalization cost (1450 USD).
- Systematic screening is approximately 2.58 times more cost-effective than managing anemia-related hospitalizations in an unscreened population.
Conclusions:
- Routine G6PD deficiency testing in newborns is an efficient strategy.
- The findings support revising screening policies to include all male infants.
Introduction:
G6PD deficiency is one of the most prevalent genetic diseases in Lebanon (1% in Lebanese males). Easy and effective screening methods exist to detect this deficiency early in newborns.
Objective:
To assess the cost-effectiveness of G6PD deficiency screening in the routine work-up of every male newborn in Lebanon.
Methods:
Of 299 babies with G6PD deficiency detected between 1999 and 2004, 139 (46.5%) were located, contacted, and surveyed for their experience of acute anemia crises.
Results:
A previous community survey had indicated a 77.8% risk for an acute anemia crisis necessitating hospitalization in unscreened patients, most often associated with consuming fava beans raw or in combination products. In contrast, only 5 (3.8%) of the 139 screened G6PD-deficient babies had ever developed a severe acute anemia crisis. The risk for hospitalization following a crisis had thus been reduced by 95% among patients screened for G6PD deficiency, compared to those unscreened. The estimated mean cost of each hospitalization, which lasts on average 7 days, is 1450 USD. The cost of screening is about 3 USD. The analysis indicates that, given the current prevalence of the deficiency and the reduction in hospitalization rates associated with knowing one's status, the cost of systematic screening is about 2.58 times lower than that of anemia-related hospitalizations in an unscreened population.
Conclusion:
The efficiency of routinely testing evidenced here supports changes in screening policies for boys.