A Cost-Effectiveness Analysis of a Pilot Neonatal Screening Program for Sickle Cell Anemia in the Republic of Angola

被引:31
作者
McGann, Patrick T. [1 ]
Grosse, Scott D. [2 ]
Santos, Brigida [3 ]
de Oliveira, Vysolela [3 ]
Bernardino, Luis [3 ]
Kassebaum, Nicholas J. [4 ,5 ]
Ware, Russell E. [1 ]
Airewele, Gladstone E. [6 ,7 ]
机构
[1] Cincinnati Childrens Hosp Med Ctr, Div Hematol, Cincinnati, OH 45229 USA
[2] Ctr Dis Control & Prevent, Natl Ctr Birth Defects & Dev Disabil, Atlanta, GA USA
[3] Hosp Pediat David Bernardino, Ctr Apoio Ao Doente Anemico, Luanda, Angola
[4] Seattle Childrens Hosp, Inst Hlth Metr & Evaluat, Dept Anesthesiol & Pain Med, Seattle, WA USA
[5] Univ Washington, Seattle, WA 98195 USA
[6] Baylor Coll Med, Texas Childrens Canc & Hematol Ctr, Houston, TX 77030 USA
[7] Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA
关键词
SYSTEMATIC ANALYSIS; GLOBAL BURDEN; DISEASE; EXPERIENCE; CHILDREN; UNIVERSAL; MORTALITY; OUTCOMES; AFRICA;
D O I
10.1016/j.jpeds.2015.08.068
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective To assess the cost-effectiveness of a pilot newborn screening (NBS) and treatment program for sickle cell anemia (SCA) in Luanda, Angola. Study design In July 2011, a pilot NBS and treatment program was implemented in Luanda, Angola. Infants identified with SCA were enrolled in a specialized SCA clinic in which they received preventive care and sickle cell education. In this analysis, the World Health Organization (WHO) and generalized cost-effectiveness analysis methods were used to estimate gross intervention costs of the NBS and treatment program. To determine healthy life-years (HLYs) gained by screening and treatment, we assumed NBS reduced mortality to that of the Angolan population during the first 5 years based upon WHO and Global Burden of Diseases Study 2010 estimates, but provided no significant survival benefit for children who survive through age 5 years. A secondary sensitivity analysis with more conservative estimates of mortality benefits also was performed. The costs of downstream medical costs, including acute care, were not included. Results Based upon the costs of screening 36 453 infants and treating the 236 infants with SCA followed after NBS in the pilot project, NBS and treatment program is projected to result in the gain of 452-1105 HLYs, depending upon the discounting rate and survival assumptions used. The corresponding estimated cost per HLY gained is $1380-$3565, less than the gross domestic product per capita in Angola. Conclusions These data demonstrate that NBS and treatment for SCA appear to be highly cost-effective across all scenarios for Angola by the WHO criteria.
引用
收藏
页码:1314 / 1319
页数:6
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