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Table of Contents
Vol. 12, No. 2, 2009
Issue release date: November 2008
Section title: Original Paper
Public Health Genomics 2009;12:67–72
(DOI:10.1159/000156115)

The Cost Effectiveness of Screening Newborns for Congenital Adrenal Hyperplasia

Yoo B.K. · Grosse S.D.
aUniversity of Rochester, School of Medicine and Dentistry, Department of Community and Preventive Medicine, Division of Health Services Research and Policy, Rochester, N.Y.; bCenters for Disease Control and Prevention (CDC), National Center on Birth Defects and Developmental Disabilities, Atlanta, Ga., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 2/27/2008
Accepted: 6/18/2008
Published online: 9/14/2008

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 2

ISSN: 1662-4246 (Print)
eISSN: 1662-8063 (Online)

For additional information: http://www.karger.com/PHG

Abstract

Objective: To assess the cost effectiveness of newborn screening for congenital adrenal hyperplasia (CAH) in the U.S. newborn population. Methods: We constructed a decision model to estimate the incremental cost-effectiveness ratio (ICER) of CAH screening compared to a strategy of no screening. Two types of cost effectiveness analyses (CEA) were conducted to measure ICER as net cost per life year (LY): (1) traditional CEA with sensitivity and scenario analyses, and (2) probabilistic CEA. Results: ICERs for (1) base-case analysis in traditional CEA and (2) probabilistic CEA were USD 292,000 and USD 255,700 per LY saved in 2005 USD, respectively. ICERs were particularly sensitive to assumptions regarding the mortality rate for the salt wasting type of CAH, in a range from 2 to 9%. The ICERs for best-case and worst-case scenarios were USD 30,900 and USD 2.9 million per LY saved, respectively. Conclusions: Using common benchmarks for cost effectiveness, our results indicate that CAH screening would be unlikely to be considered cost effective unless assumptions favorable to screening were adopted, although it could meet economic criteria used to assess U.S. regulatory policies. A limitation is that the analysis excludes outcomes such as correct assignment of gender and quality of life.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 2/27/2008
Accepted: 6/18/2008
Published online: 9/14/2008

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 2

ISSN: 1662-4246 (Print)
eISSN: 1662-8063 (Online)

For additional information: http://www.karger.com/PHG


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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