Economic evaluation of long-term impacts of universal newborn hearing screening
Shu-Ti Chiou1, Hou-Ling Lung2,3, Li-Sheng Chen4
1a Institute of Public Health , National Yang-Ming University , Taipei , Taiwan.
Objective:
Little is known about the long-term efficacious and economic impacts of universal newborn hearing screening (UNHS).
Design:
An analytical Markov decision model was framed with two screening strategies: UNHS with transient evoked otoacoustic emission (TEOAE) test and automatic acoustic brainstem response (aABR) test against no screening. By estimating intervention and long-term costs on treatment and productivity losses and the utility of life years determined by the status of hearing loss, we computed base-case estimates of the incremental cost-utility ratios (ICURs). The scattered plot of ICUR and acceptability curve was used to assess the economic results of aABR versus TEOAE or both versus no screening.
Study Sample:
A hypothetical cohort of 200,000 Taiwanese newborns.
Results:
TEOAE and aABR dominated over no screening strategy (ICUR = $-4800.89 and $-4111.23, indicating less cost and more utility). Given $20,000 of willingness to pay (WTP), the probability of being cost-effective of aABR against TEOAE was up to 90%.
Conclusions:
UNHS for hearing loss with aABR is the most economic option and supported by economically evidence-based evaluation from societal perspective.
