Document Detail

Universal or targeted screening for fetal alcohol exposure: a cost-effectiveness analysis.
MedLine Citation:
PMID:  18612566     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: In this article, we compared the costs of testing meconium for alcohol exposure in newborns with the lifetime benefits of early detection and intervention. METHOD: A decision analytic model was developed to assess the cost-effectiveness of testing meconium for two scenarios: (1) all infants in the Canadian province of Ontario and (2) infants who have an older sibling diagnosed with fetal alcohol spectrum disorder (FASD). The model incorporated the costs of early screening, early intervention, and the lifetime societal benefits of early intervention. RESULTS: The cost of the meconium test is Can. $150. The lifetime societal cost of the disease is Can. $1.3 million per incident case. The benefit of early intervention is an improvement in literacy, which improves the quality of life parameter by 0.17 and increases adult lifetime earnings by $26,400 per year. The ratio of the incremental cost to the incremental benefits results in an incremental cost-effectiveness ratio for mandating a universal screen of all newborns in Ontario of $65,874 per quality-adjusted life years. When considering targeted screening, there is a cost savings for society and improvements in quality of life. CONCLUSIONS: Depending on society's willingness-to-pay threshold for improving infants' lives in a setting of considerable equity concerns, universal screening and targeted screening of infants who have an older sibling diagnosed with FASD both represent policies that are good value for the money.
Robert B Hopkins; Jon Paradis; Tozheg Roshankar; James Bowen; Jean-Eric Tarride; Gord Blackhouse; Morgan Lim; Daria O'Reilly; Ron Goeree; Christopher J Longo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of studies on alcohol and drugs     Volume:  69     ISSN:  1937-1888     ISO Abbreviation:  -     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-09     Completed Date:  2008-09-22     Revised Date:  2009-04-29    
Medline Journal Info:
Nlm Unique ID:  101295847     Medline TA:  J Stud Alcohol Drugs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  510-9     Citation Subset:  IM    
Program for Assessment of Technology in Health, Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, 25 Main Street West, Suite 2000, Hamilton, Ontario, L8P 2A1, Canada.
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MeSH Terms
Biological Markers / analysis
Cost-Benefit Analysis
Early Intervention (Education) / economics
Fatty Acids / analysis
Fetal Alcohol Syndrome / diagnosis,  economics*,  rehabilitation
Infant, Newborn
Meconium / chemistry
Models, Economic
Neonatal Screening / economics*
Predictive Value of Tests
Quality-Adjusted Life Years
Risk Factors
Reg. No./Substance:
0/Biological Markers; 0/Fatty Acids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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