Cost-effectiveness and cost-benefit of establishing a neonatal screening programme for phenylketonuria in Libya.

Authors: E Sladkevicius, RJ Pollitt, A Mgadmi & JF Guest
Source: Applied Health Economics and Health Policy 2010; in press.

ABSTRACT

Background: To estimate the cost-effectiveness and cost-benefit of neonatal screening for phenylketonuria (PKU) compared to no neonatal screening in Libya.

Methods: A decision model was constructed to consider the consequences of neonatal screening and no neonatal screening for PKU. The model estimated the cost-effectiveness and cost-benefit of neonatal screening in US dollars ($) at 2007/08 prices, from the perspective of Libyan society.

Results: The expected discounted cost to Libyan society of screening over 15 years and managing ~374 detected PKU sufferers over their life-time was estimated to be $213.6 (95% CI: 211.9; 214.3) million. The current expected discounted cost of managing these same PKU sufferers over their life-time as a result of not screening was estimated to be $321.2 (95% CI: 318.0; 322.7) million. Hence, screening would save Libyan society $107.5 (95% CI: 105.5; 109.1) over the life-time of PKU sufferers and lead to an additional 6,950 (95% CI: 6,840; 7,060) life-years. The expected cost per undiscounted life-year gained was estimated to be -$15,500 (95% CI: -16,600; 1,100). There would be a 90% return on investment in the screening programme since society would gain $1.9 for every $1 invested.

Conclusion: Within the model’s limitations, neonatal screening for PKU appears to offer Libyan society a cost-effective and cost-beneficial strategy compared to no neonatal screening.