Cost-Justification Analysis of Prenatal Maternal Serum Alpha-feto Protein Screening
Bibliographic Data
| ID | 9099602 |
|---|---|
| Authors | Stephen H Taplin (University of Puget Sound, corresponding author), Rory Sascha Thompson (0000-0003-1593-0916, Group Health Cooperative, corresponding author), Robert S Thompson (0000-0001-9287-2954), Douglas A Conrad (University of Washington) |
| Year | 1988 |
| Volume | 26 |
| Issue | 12 |
| Pages | 1185-1202 |
| Publication date | 1988-12-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/00005650-198812000-00008 |
| PMID | 2462141 |
| OpenAlex | W2019319805 |
| Language | EN |
| References cited | 8 |
The costs to an insurer of a 10-year maternal serum alpha-feto protein (MSAFP) screening program were subtracted from future medical care costs avoided by the insurer (benefits) to examine whether such a program would be cost-justified from the perspective of a managed health care system (i.e., result in net costs greater than or equal to 0). The analysis considered MSAFP screening for neural tube defects (NTDs) alone and then was repeated to consider screening for both NTDs and Down's syndrome. Using a 5% discount rate for future dollars, the costs to the insurer of a screening program for NTDs alone over 10 years exceeded costs avoided by $10.00 per person screened. Adding screening for Down's syndrome using the same MSAFP test increased the net cost by $22.00 to a total of--$32.00 per screenee. The estimate of the cost to the insurer was sensitive to assumptions regarding the costs of medical care avoided, the expense of MSAFP, the proportion of screened women requiring a genetic amniocentesis, and the cost of that procedure. The conclusion that screening would not result in a cost savings to the insurer was not changed by reasonable assumptions regarding 1) the appropriate discount rate; 2) the costs of MSAFP; 3) the costs of genetic amniocentesis; 4) the sensitivity of MSAFP; 5) the proportion of the population requiring genetic amniocentesis; and 6) the costs of 10 years of medical care for someone affected by Down's syndrome or an NTD. Other analyses suggested that screening for NTDs or Down's syndrome would be cost-justified when viewed from the perspective of society. The present work suggests this conclusion does not hold when the perspective of the insurer is taken because avoided costs of care realized by society exceed those realized by the insurer
Alpha (finance) · Biology · Obstetrics · Patient satisfaction · Pregnancy · Fetal and Pediatric Neurological Disorders · Genetics · Medicine · Nursing · Parvovirus B19 Infection Studies · Prenatal Screening and Diagnostics
Foundations of Cost-Effectiveness Analysis for Health and Medical Practices
In California, Voluntary Mass Prenatal Screening
Cost-Benefit and Cost-Effectiveness Analysis in Health Care
Screening for spina bifida cystica. A cost-benefit analysis
Maternal serum alpha-fetoprotein screening
The Painful Prescription
Is Prevention Better Than Cure? By Louise B. Russell (Washington
An economic appraisal of screening for Down's syndrome in pregnancy using maternal age and serum alpha fetoprotein concentration
| Citation velocity | historical |
|---|---|
| Highly cited | No |