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Cost-effectiveness of different population screening strategies for hereditary haemochromatosis in Australia
Methods: A Markov model using probabilistic decision analysis was developed comparing four adult screening strategies: the status quo (cascade and incidental screening), genotyping with blood and buccal samples and transferrin saturation followed by genotyping (TfS). Target populations were males (30 years) and females (45 years) of northern European ancestry. Cost-effectiveness was estimated from the government perspective over a lifetime horizon.
Results: All strategies for males were cost-effective compared to the status quo. The incremental costs (standard deviation) associated with genotyping (blood) were AUD7 (56), TfS AUD15 (45) and genotyping (buccal) AUD63 (56), producing ICERs of AUD1673, 4103 and 15,233/quality-adjusted life-year (QALY) gained, respectively. For females, only the TfS strategy was cost-effective, producing an ICER of AUD10,195/QALY gained. Approximately 3% of C282Y homozygotes were estimated to be identified with the status quo approach, compared with 40% with the proposed screening strategies.
Conclusion: This model estimated that genotyping and TfS strategies are likely to be more cost-effective screening strategies than the status quo.
History
Publication title
Applied Health Economics and Health PolicyVolume
15Issue
4Pagination
521-534ISSN
1175-5652Department/School
Menzies Institute for Medical ResearchPublisher
Adis International Ltd.Place of publication
New ZealandRights statement
Copyright 2016 Springer International Publishing SwitzerlandRepository Status
- Restricted