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A Cost-Effectiveness Analysis of Newborn Screening for Severe Combined Immunodeficiency in the UK

School of Health and Related Research, the University of Sheffield, Sheffield S1 4DA, UK
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Int. J. Neonatal Screen. 2019, 5(3), 28; https://doi.org/10.3390/ijns5030028
Received: 25 June 2019 / Revised: 8 August 2019 / Accepted: 27 August 2019 / Published: 30 August 2019
(This article belongs to the Special Issue Selected Papers from 11th ISNS European Regional Meeting)
Severe combined immunodeficiency (SCID) can be detected through newborn bloodspot screening. In the UK, the National Screening Committee (NSC) requires screening programmes to be cost-effective at standard UK thresholds. To assess the cost-effectiveness of SCID screening for the NSC, a decision-tree model with lifetable estimates of outcomes was built. Model structure and parameterisation were informed by systematic review and expert clinical judgment. A public service perspective was used and lifetime costs and quality-adjusted life years (QALYs) were discounted at 3.5%. Probabilistic, one-way sensitivity analyses and an exploratory disbenefit analysis for the identification of non-SCID patients were conducted. Screening for SCID was estimated to result in an incremental cost-effectiveness ratio (ICER) of £18,222 with a reduction in SCID mortality from 8.1 (5–12) to 1.7 (0.6–4.0) cases per year of screening. Results were sensitive to a number of parameters, including the cost of the screening test, the incidence of SCID and the disbenefit to the healthy at birth and false-positive cases. Screening for SCID is likely to be cost-effective at £20,000 per QALY, key uncertainties relate to the impact on false positives and the impact on the identification of children with non-SCID T Cell lymphopenia. View Full-Text
Keywords: severe combined immunodeficiency; SCID; cost-effectiveness; economic; newborn screening; neonatal screening severe combined immunodeficiency; SCID; cost-effectiveness; economic; newborn screening; neonatal screening
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Bessey, A.; Chilcott, J.; Leaviss, J.; de la Cruz, C.; Wong, R. A Cost-Effectiveness Analysis of Newborn Screening for Severe Combined Immunodeficiency in the UK. Int. J. Neonatal Screen. 2019, 5, 28.

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