title: Cost-effectiveness of carrier screening for cystic fibrosis in Australia.
abstract: BACKGROUND
  Carrier screening for cystic fibrosis is not widely available in Australia, partly due to concerns regarding its cost-effectiveness. The benefit of information from pregnancy to pregnancy has not been widely considered in existing cost-effectiveness analyses.
  
  
  METHODS
  A decision tree was constructed estimating costs and outcomes from screening, including both initial and subsequent pregnancies. Effectiveness was expressed in terms of CF births averted. Costs were collected using a health service perspective. All costs and outcomes were discounted at 5% per annum.
  
  
  RESULTS
  Screening reduced the annual incidence of CF births from 34 to 14/100,000 births (an aggregate number of CF births of 100.9 and 41.9 respectively). In initial pregnancies, costs in the screening arm (A$16.6 million/100,000 births) exceed those in the non-screening arm (A$13.4 million/100,000 births). The incremental cost per CF birth in initial pregnancies is therefore approximately A$150,000. However, this was reversed for subsequent pregnancies, in that the pre-collected information reduces the incidence of CF in subsequent pregnancies at low additional costs. When aggregated, the results suggest screening is likely to be cost-saving.
  
  
  CONCLUSIONS
  The introduction of national carrier screening for cystic fibrosis should be considered, as it is likely to reduce CF incidence at an acceptable (potentially negative) cost.
authors.affiliation: Centre for Health Economics Research and Evaluation (CHERE) University of Technology, Sydney PO BOX 123, Broadway, New South Wales 2007, Australia. Richard.norman@chere.uts.edu.au
authors.forename: Richard
authors.initials: R
authors.lastname: Norman
authors.forename: Kees
authors.initials: K
authors.lastname: van Gool
authors.forename: Jane
authors.initials: J
authors.lastname: Hall
authors.forename: Martin
authors.initials: M
authors.lastname: Delatycki
authors.forename: John
authors.initials: J
authors.lastname: Massie
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003550:Cystic Fibrosis / Q000191:economics* / Q000453:epidemiology / Q000235:genetics*; D003877:Dermatitis, Contact; D005192:Family Health / Q000706:statistics & numerical data; D005260:Female; D006580:Genetic Carrier Screening; D005820:Genetic Testing / Q000191:economics*; D006579:Heterozygote; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D011247:Pregnancy; D011248:Pregnancy Complications / Q000191:economics* / Q000453:epidemiology / Q000235:genetics*