Cost-Effectiveness Analysis of Prenatal Screening Program for Thalassemia Between Semi-accelerated Screening Step and Current Program

Abstract

Background: Thalassemia is a genetic blood disorder with high incidence in Thailand. Its treatment includes blood transfusion and iron chelating therapy for life long that lead to high cost. Therefore, effective screening processes are required to prevent the newborn with thalassemia.
 Objective: To determine the cost-effectiveness of prenatal screening program for thalassemia between a semi-accelerated screening program and the current program.
 Methods: Decision tree model was developed under provider perspective. Cost, effectiveness and probabilities data were from literature review. One-way sensitivity analysis was performed to explore around inputs in the model.
 Results: The expected costs of the semi-accelerated screening program and the current program were ฿609.29 and ฿462.44, respectively. The expected outcomes to detect a severe thalassemia in fetuses from the semi-accelerated program and the current program is 34 cases and 8 cases in 10 000 couples, respectively. Incremental cost-effectiveness ratio was ฿57 499.80 per case detected.
 Conclusions: The expected costs of the semi-accelerated screening program was higher than the current programs, but the number of fetuses with thalassemia detected from the semi-accelerated screening program was more than the current programs.