PGD for all cystic fibrosis carrier couples: novel strategy for preventive medicine and cost analysis

Area of Science:

• Medical Genetics
• Reproductive Medicine
• Health Economics

Background:

• Cystic Fibrosis (CF) affects over 1000 children annually in the USA.
• In Vitro Fertilization (IVF) with Preimplantation Genetic Diagnosis (PGD) offers an alternative to managing CF or pregnancy termination.
• The economic and health impacts of CF necessitate exploring preventive strategies.

Purpose of the Study:

• To conduct a cost-benefit analysis of a national IVF-PGD program for preventing CF births.
• To compare the costs of IVF-PGD for CF carriers with the direct medical costs of treating CF patients.
• To evaluate the potential savings and health benefits of widespread IVF-PGD for CF prevention.

Main Methods:

• Cost-benefit analysis comparing IVF-PGD program costs against avoided direct medical costs of CF.
• Estimation of annual and lifetime treatment costs per CF patient.
• Calculation of cumulative net savings over 37 years for a national program.

Main Results:

• Treating 4000 CF carrier-couples annually via IVF-PGD costs $57,467 per healthy baby delivered.
• Lifetime savings per CF patient are estimated at $2.3 million, with annual savings of $2.2 billion for all new CF patients.
• A 37-year national program could yield a cumulative net saving of $33.3 billion, preventing 618,714 years of suffering.

Conclusions:

• A national IVF-PGD program for CF prevention is highly cost-effective.
• This program represents a novel preventive medicine modality.
• It can significantly reduce births of individuals with CF and associated suffering and healthcare costs.