Gj. Buffone et Jr. Beck, COST-EFFECTIVENESS ANALYSIS FOR EVALUATION OF SCREENING PROGRAMS - HEREDITARY HEMOCHROMATOSIS, Clinical chemistry, 40(8), 1994, pp. 1631-1636
A significant body of research over the last 10-20 years supports the
hypothesis that screening for hereditary hemochromatosis (HH) may be c
ost-effective, given the low-cost, low-risk therapeutic options availa
ble for most homozygous individuals. The factors that confound a strai
ghtforward test of this hypothesis include the fact that the disease i
s not fully penetrant and that, to achieve the anticipated life-year g
ains, therapy must be instituted before disease complications become i
rreversible. Recent articles and editorials, as well as practice guide
lines prepared by the College of American Pathologists, recommend scre
ening for HH with transferrin saturation and ferritin testing, and wit
h percutaneous liver biopsy for those with positive laboratory test re
sults. Patients at risk would be treated with phlebotomy for life and
monitored with ferritin testing. We present a cost-effectiveness analy
sis that evaluates the efficacy of using a screening strategy to accom
plish the desired healthcare goals.