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Newborn screening beneficial, but not always cost-saving
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Canadian Pediatric Endocrine Group
TORONTO — Analysts must consider variables other than cost savings to determine whether newborn screening of particular conditions is worthwhile, according to an economist at the Canadian Pediatric Endocrine Group 2011 Scientific Meeting.
Scott D. Grosse, PhD, a health economist and researcher from the United States, said the amount of money that analysts have claimed is saved through newborn screening is not always accurate.
“The argument that you are saving money does not always fit the facts,” Grosse said. “It is not always persuasive.”
Grosse used the example of screening for phenylketonuria. He said older analyses assumed that patients with phenylketonuria would develop severe cognitive impairments and require institutional care because the analyses assumed patients would be untreated.
“What about if you detect the condition at 1 or 2 years of life, without screening, and them put the patients on treatment?” Grosse asked. He published a review paper in 2010 on the topic of late-treated phenylketonuria.
“The majority of patients with phenylketonuria experience partial recovery. They do not require residential care, so the economic savings are not what they were made out to be [with newborn screening],” he said.
However, the reduced savings that have come to light with new analyses of old data still stress the importance of newborn screening in specific cases, according to Grosse.
“We screen to save the lives of babies and to improve the quality of life of babies,” he told Endocrine Today. “You don’t save as much money, but that does not mean that it is not worth doing.”
Currently, screening for congenital hypothyroidism is a “hot topic,” Grosse said. Some screening protocols call for using a reduced thyroid-stimulating hormone value to screen for congenital hypothyroidism.
“[Using this protocol] will detect more children with congenital hypothyroidism, but the question is what outcomes will be improved for those with mild TSH elevation,” Grosse said. – by Louise Gagnon
For more information:
- Grosse SD. Theme IV: Update on neonatal screening. Economics of newborn screening: Assessing costs and benefits. Presented at: the Canadian Pediatric Endocrine Group 2011 Scientific Meeting; Feb. 10-12, 2011; Toronto.
For more information on newborn screening:
- Grosse SD. J Pediatr. 2005;146:168-170.
- Grosse SD. Child Development. 2010;81:200-211.
- Grosse SD. Arc Dis Child; 2011;doi:10.1136/adc.2010.190280.
Disclosure: Dr. Grosse reports no relevant financial disclosures.
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