The cost-effectiveness of prenatal screening for spinal muscular atrophy
The cost-effectiveness of prenatal screening for spinal muscular atrophy
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DOI：
10.1016/j.ajog.2010.01.032
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发表时间：
2010-03-01
影响因子：
9.8
通讯作者：
Caughey, Aaron B.
中科院分区：
文献类型：
--
作者：
Little, Sarah E.;Janakiraman, Vanitha;Caughey, Aaron B.
目的：探讨脊髓性肌萎缩症（SMA）产前筛查的成本-效果。研究设计：建立一个决策分析模型来比较普遍SMA筛查和不筛查的政策。主要结局是每个产妇质量调整生命年的增量成本。通过文献回顾来估计可能性、成本和结果。进行单变量和多变量敏感性分析，以检验我们的模型对基线假设变化的稳健性。结果：SMA的普遍筛查不具有成本效益，每个质量调整生命年为490万美元。总共需要对12500名妇女进行筛查，以预防1例SMA，每避免一例病例的费用为500万美元。我们的结果对疾病的基线患病率最为敏感。结论：普遍产前筛查SMA不具有成本效益。对于高危人群，如有家族史的人群，SMA检测可能是一种具有成本效益的策略。
OBJECTIVE: We sought to investigate the cost-effectiveness of prenatal screening for spinal muscular atrophy (SMA).STUDY DESIGN: A decision analytic model was created to compare a policy of universal SMA screening to that of no screening. The primary outcome was incremental cost per maternal quality-adjusted life year. Probabilities, costs, and outcomes were estimated through literature review. Univariate and multivariate sensitivity analyses were performed to test the robustness of our model to changes in baseline assumptions.RESULTS: Universal screening for SMA is not cost-effective at $4.9 million per quality-adjusted life year. In all, 12,500 women need to be screened to prevent 1 case of SMA, at a cost of $5.0 million per case averted. Our results were most sensitive to the baseline prevalence of disease.CONCLUSION: Universal prenatal screening for SMA is not cost-effective. For populations at high risk, such as those with a family history, SMA testing may be a cost-effective strategy.