The cost-effectiveness of neonatal screening for Cystic Fibrosis: an analysis of alternative scenarios using a decision model

Table 2 Model parameters, data sources and values used in the model.

Costs (all inflated to reference year 1998)
Variable	Base case value	Range used in sensitivity analysis
Costs of screening
Additional time to explain test (survey by NS)	£0.40^a (2.1 mins)	£0 – £1.44 (0 – 7.6 mins)
Obtaining and transport of blood sample^b	£0
IRT test (Bradley DM – pers. comm.)	£0.97	£0.50 – £1.50
DNA test (Bradley DM – pers. comm.)	£79.48	£40.00 – £120.00
Sweat test (Walker S – pers. comm)	£29.40	£15.00 – £45.00
Administration and feedback of results^c	£0
Cost of pre-diagnosis care in unscreened group (audit by NS)
Presumed GP visits (mean number of visits)^d	£14.77 (1.27)	£11.63 – £46.52 (1 – 4)
Outpatient attendances (mean number)^e	£129.07 (1.47)	£0 – £263.40 (0 – 3)
Inpatient admissions (mean number of admissions and days per admission)^f	£792.55 (0.87) (3.0 days)	£0 – £1821.96 (0–2)
Costs of treatment per year in health state by age group ^g14
Presymptomatic	0–5	£2,950
	6–10	£3,995
	11–15	£4,570
	> 16	£4,275
Symptomatic	0–5	£15,241
	6–10	£15,704
	11–15	£19,247
	>16	£19,291
Severe irreversible symptoms	0–5	£28,722
	6–10	£30,692
	11–15	£37,224
	>16	£37,388

^a Whitley Councils for the Health Services Pay Scales – 1/4/98 (Nursing and Midwifery) + 16% on-costs = £11.33/hour
^bc Assumed to be a shared cost with existing screening programmes
^d The Government's Expenditures Plans 1996–97, Cost/GP consultation = £11.63
^e Annual financial returns for NHS Trusts 97/98, Cost//paediatric outpatient attendance = £87.80
^f Annual financial returns for NHS Trusts 97/98, Cost//patient-day in paediatric ward) = £303.66
^g Hospital staff, overhead and capital costs are included in the average cost per day for inpatient stays and the average cost of outpatient attendance. Drug costs were derived from the monthly index of medical specialities (MIMMS) and do not include individual hospital discount arrangements (1996 costs inflated to 1998).

ISSN: 1478-7547