COST-BENEFIT-ANALYSIS OF A NATIONAL THALASSEMIA PREVENTION PROGRAM INISRAEL

Objective-In Israel (population 5.7 million) there are around 200 know n living subjects with thalassaemia major, of whom around 80% are from the northern district. This study aims at examining the costs and ben efits of a national screening programme to prevent thalassaemia in Isr ael. Measurements and main results-The lifetime healthcare costs of ca ring for a person born with thalassaemia major are $284 154. The costs of the home infusion service (33.1%) actually exceed the costs of the chelating agent itself (22.1%). The remaining 44.8% of costs are due to stay in hospital, operations, outpatient visits. laboratory tests, therapists, etc. Lost earnings and premature mortality costs account f or a further $51 843 and $141 944 respectively for each case. A nation al screening programme would cost $900 197 and prevent around 13.4 hom ozygotes being born, at a cost of $67 369 for each birth prevented. Th e benefit-cost ratio of the programme to the health services is 4.22:1 , which increases to 6.01:1 when a societal perspective is taken. Howe ver, around 13.0 homozygote births are still expected to occur, the ma jority owing to lack of compliance of patients at various stages in th e screening process. The addition of a national health education progr amme for the higher risk non-Jewish population either nationally or in selected regions will incur extra costs, which may be covered by incr eased benefits as a result of better compliance with the screening pro gramme. Conclusion-Israel should start to provide a nationwide thalass aemia screening programme as the monetary benefits to society (and eve n to the health services alone) will exceed the screening programmes c osts.