Economic evaluation of cystic fibrosis screening: A review of the literature

Radhakrishnan, M; van Gool, K; Hall, J; Delatycki, M; Massie, J

Economic evaluation of cystic fibrosis screening: A review of the literature

Radhakrishnan, M van Gool, K

Hall, J

Delatycki, M Massie, J

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Publication Type:: Journal Article
Citation:: Health Policy, 2008, 85 (2), pp. 133 - 147
Issue Date:: 2008-02-01

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Field	Value	Language
dc.contributor.author	Radhakrishnan, M	en_US
dc.contributor.author	van Gool, K https://orcid.org/0000-0002-1424-9304	en_US
dc.contributor.author	Hall, J https://orcid.org/0000-0002-2191-0543	en_US
dc.contributor.author	Delatycki, M	en_US
dc.contributor.author	Massie, J	en_US
dc.date.available	2007-07-02	en_US
dc.date.issued	2008-02-01	en_US
dc.identifier.citation	Health Policy, 2008, 85 (2), pp. 133 - 147	en_US
dc.identifier.issn	0168-8510	en_US
dc.identifier.uri	http://hdl.handle.net/10453/9685
dc.description.abstract	Objectives: To critically examine the economic evidence regarding cystic fibrosis (CF) carrier screening and to understand issues relating to the transferability of international findings to any national context for policy decisions. Methods: A systematic literature search identified 14 studies (out of 29 economic studies on CF) focusing on preconception or prenatal screening between 1990 and 2006. These studies were then assessed against international benchmarks on conducting and reporting of economic evaluations, costing methodology used and focusing on the transferability of the evidence to national contexts. Results: The primary outcome measures varied considerably between studies and there was considerable ambiguity and variation on how costs were estimated. The Incremental Cost Effectiveness Ratio (ICER) and net savings, for preconception and prenatal screening were inconsistent and varied significantly, even after adjusting for timing and exchange rates. Differences in screening participation rates, reproductive choices, test sensitivity, cost of test and lifetime cost of care make up a large part of the ICER variations. Conclusion: The heterogeneity in study design, model inputs and reporting of economic evaluations of CF carrier screening makes comparability and transferability across countries and even within countries difficult. This reinforces the need to assess any technology within the relevant context, and to not simply generalize from reported studies. In turn, this adds to the complex task of making efficient resource allocation decisions in the area of CF carrier screening. Our evaluation adds weight to the calls for revisiting the way economic studies are conducted and reported. © 2007 Elsevier Ireland Ltd. All rights reserved.	en_US
dc.relation.ispartof	Health Policy	en_US
dc.relation.isbasedon	10.1016/j.healthpol.2007.07.007	en_US
dc.subject.classification	Health Policy & Services	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Cystic Fibrosis	en_US
dc.subject.mesh	Mass Screening	en_US
dc.subject.mesh	Victoria	en_US
dc.title	Economic evaluation of cystic fibrosis screening: A review of the literature	en_US
dc.type	Journal Article
utslib.citation.volume	2	en_US
utslib.citation.volume	85	en_US
utslib.for	1605 Policy and Administration	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Faculty of Design, Architecture and Building
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	closed_access
pubs.issue	2	en_US
pubs.publication-status	Published	en_US
pubs.volume	85	en_US

Abstract:

Objectives: To critically examine the economic evidence regarding cystic fibrosis (CF) carrier screening and to understand issues relating to the transferability of international findings to any national context for policy decisions. Methods: A systematic literature search identified 14 studies (out of 29 economic studies on CF) focusing on preconception or prenatal screening between 1990 and 2006. These studies were then assessed against international benchmarks on conducting and reporting of economic evaluations, costing methodology used and focusing on the transferability of the evidence to national contexts. Results: The primary outcome measures varied considerably between studies and there was considerable ambiguity and variation on how costs were estimated. The Incremental Cost Effectiveness Ratio (ICER) and net savings, for preconception and prenatal screening were inconsistent and varied significantly, even after adjusting for timing and exchange rates. Differences in screening participation rates, reproductive choices, test sensitivity, cost of test and lifetime cost of care make up a large part of the ICER variations. Conclusion: The heterogeneity in study design, model inputs and reporting of economic evaluations of CF carrier screening makes comparability and transferability across countries and even within countries difficult. This reinforces the need to assess any technology within the relevant context, and to not simply generalize from reported studies. In turn, this adds to the complex task of making efficient resource allocation decisions in the area of CF carrier screening. Our evaluation adds weight to the calls for revisiting the way economic studies are conducted and reported. © 2007 Elsevier Ireland Ltd. All rights reserved.

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http://hdl.handle.net/10453/9685