Screening for T1D risk to reduce DKA is not economically viable

Area of Science:

• Pediatric Endocrinology
• Health Economics
• Preventive Medicine

Background:

• Children at high risk for type 1 diabetes (T1D) can be identified via human leukocyte antigen (HLA) genotype and islet cell autoantibodies.
• Early identification of high-risk children has been linked to reduced incidence of diabetic ketoacidosis (DKA) at T1D onset.
• The cost-effectiveness of general population screening for T1D risk remains a subject of debate.

Purpose of the Study:

• To conduct an economic cost-benefit analysis of a screening program aimed at reducing DKA incidence in children under 5 years old.
• To evaluate the financial viability of T1D risk screening for preventing DKA at diagnosis.

Main Methods:

• Comparison of population screening costs against the economic benefits of DKA prevention.
• Screening costs included HLA typing for all children and periodic autoantibody testing for high-risk individuals up to age 5.
• Benefits assessed included reductions in parental lost income, medical expenses, morbidity, and mortality.

Main Results:

• Screening for T1D risk solely to reduce DKA costs was not economically viable.
• Economic viability required HLA testing costs under $1 and autoantibody testing costs under $0.03.

Conclusions:

• The current costs associated with T1D risk screening substantially outweigh the economic advantages of preventing new-onset DKA in young children.
• Further research into reducing screening costs is needed for potential future economic viability.