An economic analysis of anemia prevention during infancy.

Autor: Shaker M; Children's Hospital at Dartmouth, Lebanon, NH, USA. marcus.shaker@dartmouth.edu, Jenkins P, Ullrich C, Brugnara C, Nghiem BT, Bernstein H
Jazyk: angličtina
Zdroj: The Journal of pediatrics [J Pediatr] 2009 Jan; Vol. 154 (1), pp. 44-9. Date of Electronic Publication: 2008 Aug 29.
DOI: 10.1016/j.jpeds.2008.06.038
Abstrakt: Objective: To compare the cost-benefit profile of reticulocyte hemoglobin content (CHr) with hemoglobin (Hb) alone and Hb as a component of the complete blood count (CBC) for detection and treatment of iron deficiency in 9- to 12-month-old infants.
Study Design: Cohort simulations were used to compare CHr with Hb from a societal perspective. Assumptions included a 9% prevalence of iron deficiency and testing characteristics/costs of CHr, Hb, and CBC (CHr <27.5 pg: sensitivity 83%, specificity 72%, $11; Hb <11 g/dL: sensitivity 26%, specificity 95%, $5; CBC Hb<11g/dL, $15), as well as cost of iron therapy ($61 for established anemia). Sensitivity analyses were performed.
Results: Under current market conditions, the incremental cost to diagnose and treat iron deficiency, compared with diagnosing and treating anemia by Hb, was only $22 per patient screened ($440 per case of anemia prevented; number needed to treat = 20). With a 10-year time horizon incorporating risks and costs of neurocognitive delays associated with untreated iron deficiency, the cost of the CHr strategy was $280 per case of anemia prevented.
Conclusions: CHr is an affordable strategy to prevent anemia in infants with possible iron deficiency.
Databáze: MEDLINE
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