Potential costs and benefits of newborn screening for severe combined immunodeficiency

被引:61
作者
McGhee, SA [1 ]
Stiehm, ER
McCabe, ERB
机构
[1] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pediat, Los Angeles, CA 90095 USA
[2] Univ Calif Los Angeles, David Geffen Sch Med, Dept Human Genet, Los Angeles, CA 90095 USA
关键词
D O I
10.1016/j.jpeds.2005.06.001
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective Severe combined immunodeficiency (SCID) is a rare, treatable disorder of the immune system. The incidence is unknown but may be more common than published estimates because infants frequently die of infection before diagnosis. SCID is a candidate for universal newborn screening, so there is a need to determine under which circumstances screening would be cost-effective. Study design We assumed a screening program for SCID would use T-cell lymphopenia as the screening criterion and performed a cost-utility analysis comparing universal screening with screening only those with a family history of SCID. Results Assuming society is willing to pay $50,000 for every quality-adjusted life-year saved. a SCID screening test that cost less than $5 with a false-negative rate of 0.9% and a false-positive rate of 0.4% would be considered cost-effective. A nationwide screening program would cost an additional $23.9 million per year for screening costs but would result in 760 years of life saved per year of screening. The cost to detect I case of SCID would be $485,000. Conclusion SCID screening could result in a large benefit to detected individuals, making screening relatively cost-effective in spite of the low incidence of the disease. However, in adequate test is critical to cost-effectiveness.
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页码:603 / 608
页数:6
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