Is screening for thrombophilia cost-effective?
OBJECTIVE
The aim of this review was to examine the current evidence on the cost-effectiveness of screening for thrombophilia.


RESULTS
Few studies have attempted to evaluate the cost-effectiveness of screening for thrombophilia. The direct medical costs associated with screening, in order to detect one case of thrombophilia and indeed to prevent a subsequent venous thromboembolism, are high. Irrespective of patient groups, selective history-based thrombophilia screening has been shown to be more cost-effective than universal or unselected population screening. When comparing across the high-risk patient groups, screening women prior to prescribing combined oral contraceptives was the least cost-effective strategy.


CONCLUSIONS
Although thrombophilia is associated with a substantial increase in relative risk of venous thromboembolism, the absolute risk and the absolute numbers of expected events, and the subsequent estimated number of prevented events remain low. Based on existing evidence, screening for thrombophilia is unlikely to be cost-effective. However, the potential cost-effectiveness of thrombophilia screening may be improved if the screening strategies were to be refined through more accurate assessment of personal or family history of venous thromboembolism or the introduction of a more global coagulation test for screening.
Wu
Olivia
O
Public Health and Health Policy, University of Glasgow, Glasgow, UK.
Greer
Ian A
IA
D003276:Contraceptives, Oral / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000191:economics*; D012307:Risk Factors; D019851:Thrombophilia / Q000150:complications / Q000175:diagnosis / Q000191:economics*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000191:economics / Q000209:etiology / Q000517:prevention & control*
D003276:Contraceptives, Oral