PAP assays in newborn screening for cystic fibrosis: a population-based cost-effectiveness study
Autor: | Michel Roussey, Roch Giorgi, Caroline Cao, Valérie Seror |
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Přispěvatelé: | Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Université de Rennes (UR), Association Française pour le Dépistage et la Prévention des Handicaps de l'Enfant (AFDPHE), AFDPHE, Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES), Malbec, Odile |
Jazyk: | angličtina |
Rok vydání: | 2015 |
Předmět: |
Male
Newborn screening medicine.medical_specialty Pathology Cost effectiveness Cost-Benefit Analysis [SDV]Life Sciences [q-bio] Cystic Fibrosis Transmembrane Conductance Regulator Pancreatitis-Associated Proteins Population based micro-costing Sensitivity and Specificity Cystic fibrosis behavioral disciplines and activities cystic fibrosis 03 medical and health sciences Neonatal Screening 0302 clinical medicine Antigens Neoplasm 030225 pediatrics Internal medicine Biomarkers Tumor medicine Humans Lectins C-Type Immunoreactive trypsinogen Prospective Studies cost-effectiveness health care economics and organizations medicine.diagnostic_test business.industry Health Policy Infant Newborn Public Health Environmental and Occupational Health medicine.disease [SDV] Life Sciences [q-bio] PAP assay 030228 respiratory system Micro costing Trypsinogen Female France business psychological phenomena and processes |
Zdroj: | Journal of Medical Screening Journal of Medical Screening, 2015, 23 (2), pp.62-69. ⟨10.1177/0969141315599421⟩ Journal of Medical Screening, SAGE Publications, 2015, 23 (2), pp.62-69. ⟨10.1177/0969141315599421⟩ |
ISSN: | 0969-1413 |
DOI: | 10.1177/0969141315599421⟩ |
Popis: | Objectives To compare the cost effectiveness of adding a pancreatitis-associated protein (PAP) assay to common immunoreactive trypsinogen (IRT) and DNA cystic fibrosis (CF) newborn screening strategies. Methods Using data collected on 553,167 newborns, PAP cut-offs were calculated based on non-inferiority of the detection rates of classical forms of CF. Cost effectiveness was considered from the third-party payer's perspective using only direct medical costs, and the unit costs of PAP assays were assessed based on a micro-costing study. Robustness of the cost-effectiveness estimates was assessed, taking the secondary outcomes of screening (ie. detecting mild forms and CF carriers) into account. Results IRT/DNA, IRT/PAP, and IRT/PAP/DNA strategies had similar detection rates for classical forms of CF, but the strategies involving PAP assays detected smaller numbers of mild forms of CF. The IRT/PAP strategy was cost-effective in comparison with either IRT/DNA or IRT/PAP/DNA. IRT/PAP/DNA screening was cost-effective in comparison with IRT/DNA if relatively low value was assumed to be attached to the identification of CF carriers. Conclusions IRT/PAP strategies could be strictly cost-effective, but dropping DNA would mean the test could not detect CF carriers. IRT/PAP/DNA strategies could be a viable option as they are significantly less costly than IRT/DNA, but still allow CF carrier detection. |
Databáze: | OpenAIRE |
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