The Use of Economic Evaluation to Inform Newborn Screening Policy Decisions: The Washington State Experience

Grosse, Scott D.; Thompson, John D.; Ding, Yao; Glass, Michael

doi:10.1111/1468-0009.12196

Cited by 30 publications

(27 citation statements)

References 74 publications

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“…We believe our study provides a useful and timely economic assessment that can inform decisions on the adoption of the federally recommended SCID screen in state NBS programs. The CBA conducted in Washington 26 was a crucial step in the process of approving the adoption of SCID in that state, 59 and earlier versions of the model have been shared with other states.…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness/Cost-Benefit Analysis of Newborn Screening for Severe Combined Immune Deficiency in Washington State

Ding

Thompson

Kobrynski

et al. 2016

The Journal of Pediatrics

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Objective To evaluate the expected cost-effectiveness and net benefit of the recent implementation of newborn screening (NBS) for severe combined immunodeficiency (SCID) in Washington State. Study design We constructed a decision analysis model to estimate the costs and benefits of NBS in an annual birth cohort of 86 600 infants based on projections of avoided infant deaths. Point estimates and ranges for input variables, including the birth prevalence of SCID, proportion detected asymptomatically without screening through family history, screening test characteristics, survival rates, and costs of screening, diagnosis, and treatment were derived from published estimates, expert opinion, and the Washington NBS program. We estimated treatment costs stratified by age of identification and SCID type (with or without adenosine deaminase deficiency). Economic benefit was estimated using values of $4.2 and $9.0 million per death averted. We performed sensitivity analyses to evaluate the influence of key variables on the incremental cost-effectiveness ratio (ICER) of net direct cost per life-year saved. Results Our model predicts an additional 1.19 newborn infants with SCID detected preclinically through screening, in addition to those who would have been detected early through family history, and 0.40 deaths averted annually. Our base-case model suggests an ICER of $35 311 per life-year saved, and a benefit-cost ratio of either 5.31 or 2.71. Sensitivity analyses found ICER values <$100 000 and positive net benefit for plausible assumptions on all variables. Conclusions Our model suggests that NBS for SCID in Washington is likely to be cost-effective and to show positive net economic benefit.

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Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness/Cost-Benefit Analysis of Newborn Screening for Severe Combined Immune Deficiency in Washington State

Ding

Thompson

Kobrynski

et al. 2016

The Journal of Pediatrics

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“…Cost-effectiveness is not commonly used as a criterion for policy decisions in public health in the United States [ 68 ]. That is true specifically for newborn screening policies [ 69 ], with a few exceptions [ 70 ]. It should also be noted that most policy decisions for other types of newborn screening in European countries likewise have not been informed by cost-effectiveness analyses, although screening costs are often considered [ 71 , 72 ].…”

Section: Discussionmentioning

confidence: 99%

What Contribution Did Economic Evidence Make to the Adoption of Universal Newborn Hearing Screening Policies in the United States?

Grosse

Mason

Gaffney

et al. 2018

IJNS

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Universal newborn hearing screening (UNHS), when accompanied by timely access to intervention services, can improve language outcomes for children born deaf or hard of hearing (D/HH) and result in economic benefits to society. Early Hearing Detection and Intervention (EHDI) programs promote UNHS and using information systems support access to follow-up diagnostic and early intervention services so that infants can be screened no later than 1 month of age, with those who do not pass their screen receiving diagnostic evaluation no later than 3 months of age, and those with diagnosed hearing loss receiving intervention services no later than 6 months of age. In this paper, we first document the rapid roll-out of UNHS/EHDI policies and programs at the national and state/territorial levels in the United States between 1997 and 2005. We then review cost analyses and economic arguments that were made in advancing those policies in the United States. Finally, we examine evidence on language and educational outcomes that pertain to the economic benefits of UNHS/EHDI. In conclusion, although formal cost-effectiveness analyses do not appear to have played a decisive role, informal economic assessments of costs and benefits appear to have contributed to the adoption of UNHS policies in the United States.

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“…Both local and international studies have shown the cost-efficiencies gained by adopting MS/MS technology for expanded newborn screening. [24][25][26] The available evidence is sufficient for policymakers to consider implementing a universal expanded screening programme in Hong Kong.…”

Section: Discussionmentioning

confidence: 99%

Expanded newborn metabolic screening programme in Hong Kong: a three-year journey

et al. 2017

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The Centre of Inborn Errors of Metabolism has established a comprehensive expanded newborn screening programme for selected inborn errors of metabolism. It sets a standard against which the performance of other private newborn screening tests can be compared. Our experience can also serve as a reference for policymakers when they contemplate establishing a government-funded universal expanded newborn screening programme in the future.

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The Use of Economic Evaluation to Inform Newborn Screening Policy Decisions: The Washington State Experience

Abstract: Policy Points:r Newborn screening not only saves lives but can also yield net societal economic benefit, in addition to benefits such as improved quality of life to affected individuals and families.

Cited by 30 publications

References 74 publications

Cost-Effectiveness/Cost-Benefit Analysis of Newborn Screening for Severe Combined Immune Deficiency in Washington State

Cost-Effectiveness/Cost-Benefit Analysis of Newborn Screening for Severe Combined Immune Deficiency in Washington State

What Contribution Did Economic Evidence Make to the Adoption of Universal Newborn Hearing Screening Policies in the United States?

Expanded newborn metabolic screening programme in Hong Kong: a three-year journey

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