title: [A short-term diagnostic and economic impact model of neonatal screening for cystic fibrosis].
abstract: BACKGROUND
  Screening for cystic fibrosis (CF) is currently not a part of the neonatal screening program in Germany, but its implementation is being debated. The aim of this study was to model the short-term diagnostic and economic consequences of the implementation of such a screening.
  
  
  METHODS
  Cohort of all newborns in Germany per year.
  
  
  METHODS
  In total, 3 screening strategies were evaluated by decision modelling. The 3 screening protocols compared were alternative combinations of IRT- and DNA-testing with a final sweat test.
  
  
  RESULTS
  All modelled screening strategies show a comparable diagnostic yield (171-175 CF-cases per year). There is a tendency of slightly higher sensitivity and shorter time to diagnosis for the "IRT-DNA with failsafe" protocol. In comparison to other strategies, the total number of screening-related visits for this protocol is lower, whereas the amount of sweat tests is the highest. All screening strategies are comparable in terms of avoided cases of extremely low height- or weight-for-age (37-38 and 13-14 cases, respectively). The incremental annual diagnostic costs (with deducted diagnostic costs without screening) are 1.13 to 1.16 million EUR. After 3 years of model runtime there is a nearly neutral total budget impact of screening (diagnostic and treatment costs) per cohort.
  
  
  CONCLUSIONS
  All screening strategies lead to a considerable reduction of time to diagnosis at acceptable financial expenditures. The findings of this study broaden the current basis for discussion regarding the implementation of cystic fibrosis screening in Germany.
authors.affiliation: Gemeinsamer Bundesausschuss, Fachberatung Medizin, Berlin. andrej.rasch@g-ba.de
authors.forename: A
authors.initials: A
authors.lastname: Rasch
authors.forename: M
authors.initials: M
authors.lastname: Perleth
mesh_terms: D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000175:diagnosis* / Q000191:economics*; D003661:Decision Support Techniques; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006284:Health Plan Implementation / Q000191:economics; D006801:Humans; D007231:Infant, Newborn; D018803:Models, Economic; D009313:National Health Programs / Q000191:economics*; D015997:Neonatal Screening / Q000191:economics*; D011237:Predictive Value of Tests