COST-EFFECTIVENESS ANALYSIS FOR EVALUATION OF SCREENING PROGRAMS - HEREDITARY HEMOCHROMATOSIS

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.