Cost Comparison of Different Methods of Screening for Cystic Fibrosis

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Abstract
Objective: To compare the costs of several proposed methods of screening for cystic fibrosis. Setting: England and Wales. Methods: The costs of screening carried out at hospital antenatal clinics, general practitioner (GP) antenatal consultations, GP surgeries, and at work were estimated using data from demonstration projects. Couple screening, stepwise screening, and screening of individuals were considered. Results: Couple screening at antenatal hospital clinics was the least expensive per carrier couple detected, amounting to £35 700 (£142 900 for each potential cystic fibrosis fetus detected). The costs of the reagents (£25 per test) accounted for over 60% of this total. Conclusions: Antenatal screening, in addition to being the most cost effective method of screening, is also medically the screening method of choice as it provides information at the latest time when effective preventive action can be taken and at a time when all people to be screened are likely to be accessible. If the costs of the reagents could be reduced to £5 (still higher than the costs of most diagnostic reagents) the cost for each pregnant carrier couple offered screening would be reduced by 50% to about £18 000, and the cost of offering screening to 684 000 pregnant couples in England and Wales would be about 91/2 instead of £19m.