Newborn Screening for Cystic Fibrosis Is Associated With the Lowest Healthcare Costs: A 10-Year Observational
Erika Guyot1, Floriane Deygas1, Manon Belhassen1
1PELyon, PharmacoEpidémiologie Lyon, Lyon, France.
Insights
Newborn screening (NBS) for cystic fibrosis (CF) is linked to lower initial healthcare costs in children. However, these costs become comparable across different diagnosis groups by age ten.
Area of Science:
- Pediatric Health Economics
- Cystic Fibrosis Management
- Public Health Screening Programs
Background:
- Cystic Fibrosis (CF) diagnosis timing impacts healthcare utilization and costs.
- Understanding healthcare cost trajectories is crucial for resource allocation in CF care.
- Early detection through newborn screening (NBS) may influence long-term health outcomes and costs.
Purpose of the Study:
- To analyze healthcare (HC) costs in children with CF based on prenatal (ANT), newborn screening (NBS), meconium ileus (MI), or late symptom (LS) diagnosis.
- To characterize clinical features of children with CF (chCF) across different HC cost trajectories.
- To compare the initial and long-term HC cost differences among CF diagnosis groups.
Main Methods:
- Retrospective observational study using French CF Registry and National Claims Database (2006-2021).
- Estimation of annual HC costs per child with CF up to age 10, stratified by diagnosis circumstance.
- Group-based trajectory modeling to identify distinct cost patterns and associated clinical factors.
Main Results:
- Children diagnosed via NBS incurred lower HC costs in the first year compared to ANT and MI groups.
- Healthcare costs became statistically similar across all diagnosis groups by the tenth year of life.
- Three distinct cost trajectory groups were identified; higher cost groups showed poorer lung function and growth metrics.
Conclusions:
- Newborn screening (NBS) is associated with reduced healthcare costs during the initial year of life for children with CF.
- Clinical characteristics, including lung function and growth, correlate with long-term healthcare cost trajectories in CF patients.
Objectives:
This study aims to study the healthcare (HC) costs associated with cystic fibrosis (CF) in children diagnosed prenatally (ANT), through newborn screening (NBS), after birth due to meconium ileus (MI), or later based on symptoms (LS). Additionally, it seeks to clinically characterize children with CF (chCF) with different trajectories of HC costs.
Study Design:
A retrospective observational study was conducted on data from the French CF Registry (FCFR) and the French National Claims Database (SNDS) linked from 2006 to 2021. HC costs related to CF diagnosis circumstances were estimated per year of life among chCF up to age 10. Group-based trajectory modeling was performed to identify subgroups with similar cost trajectories.
Results:
Between 2006 and 2011, data from 1065 chCF were recorded in the FCFR. Nine hundred seventy-three (91.4%) were matched with SNDS, and 779 (73.1%) had at least 10 years of follow-up. During the first year, HC costs of chCF diagnosed with NBS were lower than for those diagnosed with MI and ANT (all p < 0.05). However, by the tenth year HC were no longer different between groups. Three groups with different cost trajectories were identified. Groups with the highest costs had a lower lung function at 6 and 10 years and the lowest weight and height z-scores at 2 and 10 years (all p < 0.05).
Conclusion:
NBS is associated with the lowest HC costs during the first year of life.
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