title: Methods for developing useful estimates of the costs associated with birth defects.
abstract: BACKGROUND
  Cost estimates for birth defects are useful to policy makers in deciding the best use of resources to prevent these conditions. Much of the effort in this area has focused on spina bifida, in part because cost savings can be estimated from folic acid-preventable cases. However, comprehensive cost-of-illness estimates for this condition may be too outdated, too general, or not applicable to individual states' environments.
  
  
  METHODS
  Using the live birth prevalence for spina bifida in Texas, we applied recent spina bifida cost estimates to approximate total lifetime medical and other costs for an average live birth cohort of spina bifida cases in Texas. In addition, we queried various government programs that provide services for persons with spina bifida to provide program-specific annual costs for this condition.
  
  
  RESULTS
  Applying a recently published average lifetime medical cost of $635,000 per case of spina bifida to the average annual birth cohort of 120 Texas cases, an estimated $76 million in direct and indirect medical and other costs will be incurred in Texas over the life span of that cohort. Examples of estimated medical costs for one year are $5 million for infants using actual employer-paid insurance claims data and $6 million combined for children in two public sector programs.
  
  
  CONCLUSIONS
  Stakeholders and state policy makers may look to state birth defects registries for useful cost data. Although comprehensive state-specific figures are not available, applying prevalence data to existing estimates and obtaining actual claims and program expenditures may help close this information gap.
authors.affiliation: Texas Department of State Health Services, Birth Defects Epidemiology and Surveillance Branch, Mail Code 1964, P.O. Box 149347, Austin, TX 78714-9347, USA. amy.case@dshs.state.tx.us
authors.forename: Amy P
authors.initials: AP
authors.lastname: Case
authors.forename: Mark A
authors.initials: MA
authors.lastname: Canfield
mesh_terms: D000013:Congenital Abnormalities / Q000191:economics*; D017281:Cost of Illness; D006801:Humans; D015995:Prevalence; D012042:Registries; D016135:Spinal Dysraphism / Q000191:economics / Q000453:epidemiology; D013781:Texas / Q000453:epidemiology