[Cost-effectiveness of neonatal screening for 3-hydroxy-3-methylglutaric aciduria (HMG)]

Castilla I, Vallejo-Torres L, Linertová R, Ferrer J, Rivas Wagner E, DulínÍñiguez E, Valcárcel-Nazco C, García-Pérez L, Serrano-Aguilar P
Record ID 32018013035
Spanish
Original Title: Coste-efectividad del cribado neonatal de la aciduria 3-hidroxi-3-metilglutárica (HMG)
Authors' objectives: To determine the efficiency, in terms of cost-effectiveness, of the incorporation of HMG early detection in the neonatal screening program and its budgetary impact.
Authors' results and conclusions: RESULTS: According to the results of this economic evaluation, the neonatal screening of HMG is more expensive and there is no evidence that it is more effective than the clinical detection. Considering the number of births per year in Spain of 450,000, the increase in costs if HMG screening is implemented would be € 26,759.90 (€ 0.06 per infant). Under a number of assumptions, probabilistic sensitivity analysis estimated a 23.8% probability that the neonatal screening for this disease is cost-effective for a willingness to pay of € 30,000 / QALY. The budgetary impact for the total annual births was estimated for Spain at € 26,290 the first year, remaining almost constant up to five years (€ 26,611). CONCLUSIONS: With the evidence available at the time of preparation of this report we can not conclude that the introduction of HMG into the neonatal screening is cost-effective. Under a number of assumptions, and a willingness to pay at € 30,000 / QALY, the probability that the HMG screening is cost-effective is low, around 13.5%.
Authors' methods: We have developed a cost-effectiveness model comparing two alternatives: implanting HMG neonatal screening against the clinical detection of this disease. The model follows the infants throughout their life, reflecting the impact of preventive treatments that can be set up through early detection. The perspective of the analysis was the one of National Health System, taking into account the direct costs, expressed in euro 2014. Costs relating to the screening program were estimated including the cost of screening tests, confirmatory tests and costs of treatment and monitoring of early detected patients. These costs were compared to the costs of treating HMG not detected through newborn screening. In turn, we compare the costs with the effectiveness of the screening program. The effectiveness was measured in quality-adjusted life years (QALY) gained. Both costs and effectiveness were discounted at 3%. Probabilistic sensitivity analysis was performed using Monte Carlo simulations. Finally the budgetary impact of incorporating neonatal screening of HMG for a five years time horizont was analyzed.
Details
Project Status: Completed
Year Published: 2015
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: Spain
MeSH Terms
  • Neonatal Screening
  • Acetyl-CoA C-Acetyltransferase
  • Amino Acid Metabolism, Inborn Errors
  • Infant, Newborn
  • Cost-Effectiveness Analysis
Keywords
  • Neonatal screening
  • 3-Hydroxy-3-Methylglutaric Aciduria (HMG)
  • Cost-effectiveness
Contact
Organisation Name: Canary Health Service
Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife
Contact Name: sescs@sescs.es
Contact Email: sescs@sescs.es
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.