PAP assays in newborn screening for cystic fibrosis: a population-based cost-effectiveness study

Autor: Michel Roussey, Roch Giorgi, Caroline Cao, Valérie Seror
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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