The costs and benefits of screening for PKU in Wisconsin

Abstract

A comprehensive benefit-cost analysis of the screening program to detect newborns with PKU in Wisconsin is presented. Classic PKU is a genetic disorder which, if undetected and untreated during the first few weeks of life, generally results in mental retardation and a variety of other abnormal conditions. Monetary costs of the detection and treatment program were compared with the projected benefits (avoided costs) that result from the prevention of the mental retardation associated with the disorder. Future costs and benefits were determined using a 4 per cent, 7 per cent, and 10 per cent rate of discount. Net benefits (benefits-costs) for detecting and treating one individual with PKU were $208,000 ($292,000-$84,000) using the 7 per cent rate of discount. Net benefits for detecting four individuals with PKU per year in Wisconsin totaled $832,000, a large rate of return on a relatively small investment. The issue of the potential economic implications of maternal PKU is briefly discussed.

Newborn Screening by Tandem Mass Spectrometry for Medium-Chain Acyl-CoA Dehydrogenase Deficiency: A Cost-Effectiveness Analysis

“…Our results indicate that instituting universal newborn screening for MCADD can be achieved at an incremental cost of $5600 per QALY saved, or $11 000 per life-year saved, over a 20-year horizon and is therefore a highly cost-effective intervention. [47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62] The case for screening is further strengthened when the incremental ratio over a 70-year horizon is considered, as the respective ratios are $100 and $300. Probabilistic sensitivity analysis yielded 95% CIs for the estimated incremental cost-effectiveness ratios, with upper limits that equaled $17 100/ QALY ($33 800/life-year) for the 20-year horizon and $6900/QALY ($13 000/life-year) for the 70-year ho- rizon.…”

Detección neonatal en el Paraguay. Brechas para su cobertura universal

“…Otros países han mostrados incluso ratios más altos. Los mayores beneficios son los de evitar las cargas que para la sociedad y la familia suponen los costos de los niños con retraso mental (25,26).…”

Newborn screening for inborn errors of metabolism: a systematic review.

“…Twelve published economic evaluation studies were identified (Table 25). 132,[157][158][159][160][161][162][163][164][165][166][167] Ten of these [157][158][159][160][161][162][163][164][165][166] were CBAs, with quantification of monetary costs and benefits. Two were simpler cost-effectiveness analyses (CEAs) 132,167 which calculated only the cost of screening per case detected.…”

“…In all there were eight studies [157][158][159][160][161]163,164,166 in which the costs and benefits of neonatal screening for PKU were estimated (see Table 26). These covered very different populations and the number of cases detected varied considerably, from 1.2 to 17.9 per 100,000 babies screened.…”

“…For example, estimates of the duration of dietary treatment ranged from 2 years 160 to 20 years. 159 Current thinking is that the latter is more appropriate. Only two papers 157,161 included the costs of treatment during pregnancy for mothers with PKU.…”