Cost-effectiveness analysis of carrier and prenatal genetic testing for X-linked hemophilia
Hemophilia involves a lifelong burden from the perspective of the patient and the entire healthcare system. Advances in genetic testing provide valuable information to hemophilia-affected families for family planning. The aim of this study was to analyze the cost-effectiveness of carrier and prenata...
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| Format: | Article |
| Language: | English |
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Elsevier
2015-08-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664613002210 |
| _version_ | 1818850725995741184 |
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| author | Meng-Che Tsai Chao-Neng Cheng Ru-Jay Wang Kow-Tong Chen Mei-Chin Kuo Shio-Jean Lin |
| author_facet | Meng-Che Tsai Chao-Neng Cheng Ru-Jay Wang Kow-Tong Chen Mei-Chin Kuo Shio-Jean Lin |
| author_sort | Meng-Che Tsai |
| collection | DOAJ |
| description | Hemophilia involves a lifelong burden from the perspective of the patient and the entire healthcare system. Advances in genetic testing provide valuable information to hemophilia-affected families for family planning. The aim of this study was to analyze the cost-effectiveness of carrier and prenatal genetic testing in the health-economic framework in Taiwan.
Methods: A questionnaire was developed to assess the attitudes towards genetic testing for hemophilia. We modeled clinical outcomes of the proposed testing scheme by using the decision tree method. Incremental cost-effectiveness analysis was conducted, based on data from the National Health Insurance (NHI) database and a questionnaire survey.
Results: From the NHI database, 1111 hemophilic patients were identified and required an average medical expenditure of approximately New Taiwan (NT) $2.1 million per patient-year in 2009. By using the decision tree model, we estimated that 26 potential carriers need to be tested to prevent one case of hemophilia. At a screening rate of 79%, carrier and prenatal genetic testing would cost NT $85.9 million, which would be offset by an incremental saving of NT $203 million per year by preventing 96 cases of hemophilia. Assuming that the life expectancy for hemophilic patients is 70 years, genetic testing could further save NT $14.2 billion. Higher screening rates would increase the savings for healthcare resources.
Conclusion: Carrier and prenatal genetic testing for hemophilia is a cost-effective investment in healthcare allocation. A case management system should be integrated in the current practice to facilitate patient care (e.g., collecting family pedigrees and providing genetic counseling). |
| first_indexed | 2024-12-19T06:53:42Z |
| format | Article |
| id | doaj.art-371e77575bcf4b5a967bfc79f1d4c126 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-19T06:53:42Z |
| publishDate | 2015-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-371e77575bcf4b5a967bfc79f1d4c1262022-12-21T20:31:37ZengElsevierJournal of the Formosan Medical Association0929-66462015-08-01114872272810.1016/j.jfma.2013.06.017Cost-effectiveness analysis of carrier and prenatal genetic testing for X-linked hemophiliaMeng-Che Tsai0Chao-Neng Cheng1Ru-Jay Wang2Kow-Tong Chen3Mei-Chin Kuo4Shio-Jean Lin5Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Public Health, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Public Health, College of Medicine, National Cheng Kung University, Tainan, TaiwanDepartment of Pediatrics, Chi-Mei Hospital, Tainan, TaiwanDepartment of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TaiwanHemophilia involves a lifelong burden from the perspective of the patient and the entire healthcare system. Advances in genetic testing provide valuable information to hemophilia-affected families for family planning. The aim of this study was to analyze the cost-effectiveness of carrier and prenatal genetic testing in the health-economic framework in Taiwan. Methods: A questionnaire was developed to assess the attitudes towards genetic testing for hemophilia. We modeled clinical outcomes of the proposed testing scheme by using the decision tree method. Incremental cost-effectiveness analysis was conducted, based on data from the National Health Insurance (NHI) database and a questionnaire survey. Results: From the NHI database, 1111 hemophilic patients were identified and required an average medical expenditure of approximately New Taiwan (NT) $2.1 million per patient-year in 2009. By using the decision tree model, we estimated that 26 potential carriers need to be tested to prevent one case of hemophilia. At a screening rate of 79%, carrier and prenatal genetic testing would cost NT $85.9 million, which would be offset by an incremental saving of NT $203 million per year by preventing 96 cases of hemophilia. Assuming that the life expectancy for hemophilic patients is 70 years, genetic testing could further save NT $14.2 billion. Higher screening rates would increase the savings for healthcare resources. Conclusion: Carrier and prenatal genetic testing for hemophilia is a cost-effective investment in healthcare allocation. A case management system should be integrated in the current practice to facilitate patient care (e.g., collecting family pedigrees and providing genetic counseling).http://www.sciencedirect.com/science/article/pii/S0929664613002210carrier testingeconomic analysisethicshemophiliaprenatal diagnosis |
| spellingShingle | Meng-Che Tsai Chao-Neng Cheng Ru-Jay Wang Kow-Tong Chen Mei-Chin Kuo Shio-Jean Lin Cost-effectiveness analysis of carrier and prenatal genetic testing for X-linked hemophilia Journal of the Formosan Medical Association carrier testing economic analysis ethics hemophilia prenatal diagnosis |
| title | Cost-effectiveness analysis of carrier and prenatal genetic testing for X-linked hemophilia |
| title_full | Cost-effectiveness analysis of carrier and prenatal genetic testing for X-linked hemophilia |
| title_fullStr | Cost-effectiveness analysis of carrier and prenatal genetic testing for X-linked hemophilia |
| title_full_unstemmed | Cost-effectiveness analysis of carrier and prenatal genetic testing for X-linked hemophilia |
| title_short | Cost-effectiveness analysis of carrier and prenatal genetic testing for X-linked hemophilia |
| title_sort | cost effectiveness analysis of carrier and prenatal genetic testing for x linked hemophilia |
| topic | carrier testing economic analysis ethics hemophilia prenatal diagnosis |
| url | http://www.sciencedirect.com/science/article/pii/S0929664613002210 |
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