CFDB - Cystic Fibrosis DataBase

NHSEED - Economic Study or Review

A decision-tree approach to cost comparison of newborn screening strategies for cystic fibrosis

Study design (if review, criteria of inclusion for studies)

Simulation approach with decision trees analysis.




Immunoreactive trypsinogen (IRT) screening followed by a second IRT test against an IRT/DNA analysis.

Outcome measures

The numbers of newborns given a diagnosis of cystic fibrosis and costs of screening strategy at each branch and cost per newborn.

Main results

Simulations revealed a substantial number of potential missed diagnoses for the IRT/IRT system versus IRT/DNA. Although the IRT/IRT strategy with commonly used cutoff values offers an average overall cost savings of $2.30 per newborn, a breakdown of costs by societal segments demonstrated higher out-of-pocket costs for families. Two potential system failures causing delayed diagnoses were identified relating to the screening protocols and the follow-up system.

Authors' conclusions

The IRT/IRT screening algorithm reduces the costs to laboratories and insurance companies but has more system failures. IRT/DNA offers other advantages, including fewer delayed diagnoses and lower out-of-pocket costs to families.

Keywords: Neonatal Screening; Newborn; non pharmacological intervention - diagn; screening; diagnostic procedures;