TY - JOUR
T1 - Economic implications of newborn screening for cystic fibrosis: a cost of illness retrospective cohort study
AU - Sims, Erika J.
AU - Mugford, Miranda
AU - Clark, Allan
AU - Aitken, David
AU - McCormick, Jonathan
AU - Mehta, Gita
AU - Mehta, Anil
N1 - dc.publisher: Elsevier
... on behalf of the UK Cystic Fibrosis Database Steering Committee.
PY - 2007/4
Y1 - 2007/4
N2 - Background Newborn screening for cystic fi brosis might not be introduced if implementation and running costs are perceived as prohibitive. Compared with clinical diagnosis, newborn screening is associated with clinical benefi t and reduced treatment needs. We estimate the potential savings in treatment costs attributable to newborn screening. Methods Using the UK Cystic Fibrosis Database, we used a prevalence strategy to undertake a cost of illness retrospective snapshot cohort study. We estimated yearly costs of long-term therapies and intravenous antibiotics for 184 patients who were diagnosed as a result of screening as newborn babies, and 950 patients who were clinically diagnosed aged 1–9 years in 2002. Costs of adding cystic fi brosis screening to an established newborn screening service in Scotland were adjusted to 2002 prices and applied to the UK as a whole. Costs were recalculated in US$. Findings Cost of therapy for patients diagnosed by newborn screening was signifi cantly lower than equivalent therapies for clinically diagnosed patients: mean ($7228 vs $12 008, 95% CI of diff erence -6736 to -2028, p<0·0001) and median ($352 vs $2442, -1916 to -180, p<0·0001). When we limited the clinically diagnosed group to only those diagnosable with a 31 cystic fi brosis transmembrane regulator mutation assay and assumed similar disease progression in the clinically diagnosed group as in the newborn screening group, we showed that mean ($3 397 344) or median ($947 032) drug cost savings could have off set the estimated cost of adding cystic fi brosis to a UK national newborn screening service ($2 971 551). Interpretation Including indirect costs savings, newborn screening for cystic fi brosis might have even greater fi nancial benefi ts to society than our estimate shows. Clinical, social, and now economic evidence suggests that universal newborn screening programmes for cystic fi brosis should be adopted internationally
AB - Background Newborn screening for cystic fi brosis might not be introduced if implementation and running costs are perceived as prohibitive. Compared with clinical diagnosis, newborn screening is associated with clinical benefi t and reduced treatment needs. We estimate the potential savings in treatment costs attributable to newborn screening. Methods Using the UK Cystic Fibrosis Database, we used a prevalence strategy to undertake a cost of illness retrospective snapshot cohort study. We estimated yearly costs of long-term therapies and intravenous antibiotics for 184 patients who were diagnosed as a result of screening as newborn babies, and 950 patients who were clinically diagnosed aged 1–9 years in 2002. Costs of adding cystic fi brosis screening to an established newborn screening service in Scotland were adjusted to 2002 prices and applied to the UK as a whole. Costs were recalculated in US$. Findings Cost of therapy for patients diagnosed by newborn screening was signifi cantly lower than equivalent therapies for clinically diagnosed patients: mean ($7228 vs $12 008, 95% CI of diff erence -6736 to -2028, p<0·0001) and median ($352 vs $2442, -1916 to -180, p<0·0001). When we limited the clinically diagnosed group to only those diagnosable with a 31 cystic fi brosis transmembrane regulator mutation assay and assumed similar disease progression in the clinically diagnosed group as in the newborn screening group, we showed that mean ($3 397 344) or median ($947 032) drug cost savings could have off set the estimated cost of adding cystic fi brosis to a UK national newborn screening service ($2 971 551). Interpretation Including indirect costs savings, newborn screening for cystic fi brosis might have even greater fi nancial benefi ts to society than our estimate shows. Clinical, social, and now economic evidence suggests that universal newborn screening programmes for cystic fi brosis should be adopted internationally
U2 - 10.1016/S0140-6736(07)60565-0
DO - 10.1016/S0140-6736(07)60565-0
M3 - Article
SN - 0140-6736
VL - 369
SP - 1187
EP - 1195
JO - Lancet
JF - Lancet
IS - 9568
ER -