The effects of neonatal screening for sickle cell disorders on lifetime treatment costs and early deaths avoided: a modelling approach.
BACKGROUND
The aim of the study was to calculate the cost to the UK National Health Service of providing treatment services for patients with sickle cell disorders. The rates of differential morbidity and mortality, in the first 10 years of life, between screen-detected early diagnosed and clinically presenting late diagnosed cohorts of sickle cell disorder patients are also estimated.


METHODS
A cost model was developed, based on predictions of survival and the incidence of sickle cell disorder-related events. Direct data from the NHS are lacking, so data were incorporated from disparate sources. Patients with sickle cell disorders were divided into two categories: those with sickle cell anaemia and those with sickle HbC disease.


RESULTS
Differentiating between sickle cell anaemia and sickle HbC disorder patients, the results show that the undiscounted (discounted at 6 per cent) lifetime treatment costs range from pound sterling 92323 (pound sterling 24917) to pound sterling 185614 (pound sterling 53861). The number of early deaths avoided per 100 births, as a result of early diagnosis through screening, ranges from 0.57 to 1.25.


CONCLUSIONS
The resulting estimates may act as a guide to those involved in the planning of health care provision with regard to the resources required to treat sickle cell disorder patients. Such information may also be incorporated into the evaluation of both antenatal and neonatal screening programmes for sickle cell disorders.
Karnon
J
J
Health Economics Research Group, Brunel University, Uxbridge. jonathan.karnon@brunel.ac.uk
Zeuner
D
D
Ades
A E
AE
Efimba
W
W
Brown
J
J
Yardumian
A
A
D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D017059:Models, Econometric; D015997:Neonatal Screening / Q000191:economics*; D011247:Pregnancy; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology