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Applied Health Economics and Health Policy
Published in: Applied Health Economics and Health Policy 4/2017

01-08-2017 | Original Research Article

Cost-Effectiveness of Different Population Screening Strategies for Hereditary Haemochromatosis in Australia

Authors: Barbara de Graaff, Amanda Neil, Lei Si, Kwang Chien Yee, Kristy Sanderson, Lyle Gurrin, Andrew J. Palmer

Published in: Applied Health Economics and Health Policy | Issue 4/2017

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Abstract

Introduction

Amongst populations of northern European ancestry, HFE-associated haemochromatosis is a common genetic disorder characterised by iron overload. In the absence of treatment, excess iron is stored in parenchymal tissues, causing morbidity and mortality. Population screening programmes may increase early diagnosis and reduce associated disease. No contemporary health economic evaluation has been published for Australia. The objective of this study was to identify cost-effective screening strategies for haemochromatosis in the Australian setting.

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.
Appendix
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Metadata
Title
Cost-Effectiveness of Different Population Screening Strategies for Hereditary Haemochromatosis in Australia
Authors
Barbara de Graaff
Amanda Neil
Lei Si
Kwang Chien Yee
Kristy Sanderson
Lyle Gurrin
Andrew J. Palmer
Publication date
01-08-2017
Publisher
Springer International Publishing
Published in
Applied Health Economics and Health Policy / Issue 4/2017
Print ISSN: 1175-5652
Electronic ISSN: 1179-1896
DOI
https://doi.org/10.1007/s40258-016-0297-3

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