Cost-effectiveness of neonatal IgE-screening for atopic allergy before 7 years of age

Obvious atopic diseases developed in 18% of 1651 non-selected children before 7 years of age. More than 80% of newborns with high IgE concentrations in cord blood developed atopic diseases before this age. Although the sensitivity of the IgE test is rather low (40%), most cases (94%) of severe, long-lasting atopic disease show a high neonatal IgE concentration, and the specificity of the test is high (94%). Calculations of total costs of screening were made on the basis of family history alone compared with neonatal IgE-screening in two groups: all newborn infants, or infants with a family history of atopic disease. The cost of preventive measures and treatment costs were included in the calculations. Results were compared with the cost of conventional treatment. Provided that preventive measures delay onset of symptoms in atopic-risk subjects (and assuming total patient compliance) then IgE-screening was cost-effective in both groups, which screening solely on a basis of family history was not. In Sweden there was a total saving of approx. 20 million SEK or 3 million US$ per annum. Thus, IgE-screening of cord blood to select newborns for preventive measures is also economically worthwhile.