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Scott D. Ramsey, MD, PhD, Medicine/Division of General Internal Medicine, Fred Hutchinson Cancer Research Center, University of Washington, 1100 Fairview Avenue North, M2-B230, Seattle, WA 98109-1024, Catharine Riley, MPH, Institute for Public Health Genetics, University of Washington, University of Washington, Box 357236, Seattle, WA 98195, 206-616-4979, firstname.lastname@example.org, Wylie Burke, MD, PhD, Medical History and Ethics, University of Washington, University of Washington, Box 357120, Seattle, WA 98195-7120, Carolyn Watts, PhD, Department of Health Services, University of Washington, Box 357660, Seattle, WA 98195, and Lauren Clarke, MS, Center for Genomics and Healthcare Equality, University of Washington, Box 357120, Seattle, WA 98195.
Newborn screening represents an important intersection between public health and genetics. There has been an increase in the number of disorders included in state newborn screening (NBS) programs since the distribution of the American College of Medical Genetics' report, Newborn Screening: Toward a Uniform Screening Panel and System. The number of disorders included in NBS panels can have a substantial influence on programmatic obligations for states with attendant budgetary implications. Increases in costs can be particularly problematic for state health programs that face pressures because of rising Medicaid budgets. Our review of NBS programs indicates that choices about the number and type of disorders on a panel, scope of follow up services, and fee structure affect the budgetary impact of these programs. To address these issues, we have developed a decision model for determining the clinical and economic impact of alternative NBS screening panels vs. standard care based on clinical diagnoses. The model accounts for the costs of follow-up for true positive and false positive test results, and costs and potential savings associated with early therapy. The model, which takes the perspective of a state Medicaid program, estimates the financial consequences of the addition of newborn screening for cystic fibrosis (CF) to a state's NBS panel. This programmatic review and budget impact model can assist public health practitioners and policymakers in considering trade-offs involved in adding newborn screening for CF to current screening panels.
Keywords: Cost Issues, Genetics
Presenting author's disclosure statement:
Any relevant financial relationships? No
The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA