Screening for sickle cell and thalassaemia in primary care: a cost-effectiveness study.
Br J Gen Pract
; 61(591): e620-7, 2011 Oct.
Article
en En
| MEDLINE
| ID: mdl-22152833
ABSTRACT
BACKGROUND:
Haemoglobinopathies, including sickle cell disease and thalassaemia (SCT), are inherited disorders of haemoglobin. Antenatal screening for SCT rarely occurs before 10 weeks of pregnancy.AIM:
To explore the cost-effectiveness of offering SCT screening in a primary care setting, during the pregnancy confirmation visit. DESIGN ANDSETTING:
A model-based cost-effectiveness analysis of inner-city areas with a high proportion of residents from ethnic minority groups.METHOD:
Comparison was made of three SCT screening approaches 'primary care parallel' (primary care screening with test offered to mother and father together); 'primary care sequential (primary care screening with test offered to the mother and then the father only if the mother is a carrier); and 'midwife care' (sequential screening at the first midwife consultation). The model was populated with data from the SHIFT (Screening for Haemoglobinopathies In First Trimester) trial and other sources.RESULTS:
Compared to midwife care, primary care sequential had a higher NHS cost of £34,000 per 10,000 pregnancies (95% confidence interval [CI] = £15,000 to £51,000) and an increase of 2623 women screened (95% CI 1359 to 4495), giving a cost per additional woman screened by 10 weeks of £13. Primary care parallel was dominated by primary care sequential, with both higher costs and fewer women screened.CONCLUSION:
The policy judgement is whether an earlier opportunity for informed reproductive choice has a value of at least £13. Further work is required to understand the value attached to earlier informed reproductive choices.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
/
5_ODS3_mortalidade_materna
Problema de salud:
1_financiamento_saude
/
5_maternal_care
Asunto principal:
Complicaciones Hematológicas del Embarazo
/
Diagnóstico Prenatal
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Atención Primaria de Salud
/
Talasemia
/
Anemia de Células Falciformes
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Health_economic_evaluation
/
Prognostic_studies
/
Screening_studies
Límite:
Female
/
Humans
/
Pregnancy
País/Región como asunto:
Europa
Idioma:
En
Revista:
Br J Gen Pract
Año:
2011
Tipo del documento:
Article