Cost-Utility of Screening Program for Neonatal Hypothyroidism in Iran

[摘要] Background:Hypothyroidism,apreventablecauseofmentalretardation,isoneofthemostcommondiseasesoftheendocrineglandinchildren.Thedisordercanbecorrectedifitisidentifiedandtreatedwithinthefirstfewdaysofbirth.InIran,hypothyroidismisestimatedtoaffectoneoutof400to900neonates,whichismuchhigherthantheglobalaverage.Objectives:Thisarticleisconductedtoinvestigatethemostcost–utilityoptioni.e.whethertoimplementtheneonatalscreeningofgenetichypothyroidismortomerelytreatsuchpatientsintheabsenceofthescreeningprocess.PatientsandMethods:Thepresentresearchisacross-sectional,descriptiveandanalyticalstudy.TheproviderperspectivewasemployedtocalculatethedirectcostsimposedonShirazUniversityofMedicalSciences,insuranceorganizations,charitiesandpatientsconcerningtheimplementationofscreeningprogramandthetreatmentofdetectedcasesalongwiththedirectcostsrelatedtopatientstreatedintheabsenceofthescreeningprocess;costsrelatedtodeathwereexcluded.Thestatisticalpopulationofthestudyconsistedofall81837newbornsreferredtouniversitylaboratoryinShirazin2010.Inordertomeasuretheutility,time-trade-offmethodwasemployedtodeterminethelifequalityofpatients.Results:Theincrementalcost-effectivenessratios(ICER)ofhypothyroidism,calculatedthroughdividingthecostdifference(∆C)byutilitydifference(∆QALY),indicatedthatscreeningsavedatotalof13413US.$.Conclusions:Theeconomicevaluation(cost-utilityanalysis)resultedfromthecomparisonoftheabovechoicesrevealedthatimplementingthescreeningplancanactuallybebetterandmorecost-effective.

[学科分类] 基础医学

[关键词] Cost-utility Analysis;Congenital Hypothyroidism;Neonatal Screening