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  1. A comparative cost analysis of newborn screening for classic congenital adrenal hyperplasia in Texas.

    Article - En anglais

    Objective

    Texas mandates a two-test newborn screening program for congenital adrenal hyperplasia (CAH) : one test at birth and a second test at approximately one to two weeks after birth.

    The authors compared the dollar cost of detecting infants with CAH clinically and through the screening program.

    Methods

    The authors estimated the costs of screening newborns in 1994 for CAH, including resources used by the Texas Department of Health and the broader cost to society.

    Results

    Fifteen infants with classic CAH were diagnosed in Texas in 1994 among 325,521 infants born (1 : 21,701 cumulative incidence).

    Seven infants were detected clinically and the others were detected through screening, six on the first screen and two on the second screen.

    The first screen identified all previously undetected infants with severe salt-wastin CAH.

    The cumulative cost to diagnose the seven infants detected clinically was $79,187.

    The incremental costs for the screening program were $115,169 per additional infant diagnosed through the first screen and $242,865 per additional infant diagnosed through the second screen.

    Conclusions

    If the goal is early diagnosis of infants with the severe salt-wasting form of CAH, a single screen is effective.

    If the goal is to detect infants with the simple virilizing form of the disorder who many benefit from early treatment, the second screen is necessary, but it is not as cost-effective as the first screen.

    Mots-clés Pascal : Programme sanitaire, Dépistage, Diagnostic, Hyperplasie surrénale congénitale syndrome, Analyse coût, Etude comparative, Nouveau né, Homme, Economie santé, Etats Unis, Amérique du Nord, Amérique, Endocrinopathie, Surrénale pathologie, Corticosurrénale pathologie, Hypercorticisme, Enzymopathie

    Mots-clés Pascal anglais : Sanitary program, Medical screening, Diagnosis, Congenital adrenal hyperplasia syndrome, Cost analysis, Comparative study, Newborn, Human, Health economy, United States, North America, America, Endocrinopathy, Adrenal gland diseases, Adrenal cortex diseases, Hyperadrenocorticism, Enzymopathy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0232572

    Code Inist : 002B21B01. Création : 11/09/1998.