The effects of neonatal screening for sickle cell disorders on lifetime treatment costs and early deaths avoided: a modelling approach

Background The aim of the study was to calculate the cost to the UK Nationa l Health Service of providing treatment services for patients with sickle c ell disorders. The rates of differential morbidity and mortality, in the fi rst 10 years of life, between screen-detected early diagnosed and clinicall y presenting late diagnosed cohorts of sickle cell disorder patients are al so estimated. Method A cost model was developed, based on predictions of survival and the incidence of sickle cell disorder-related events. Direct data from the NHS are lacking, so data were incorporated from disparate sources. Patients wi th sickle cell disorders were divided into two categories: those with sickl e cell anaemia and those with sickle HbC disease. Results Differentiating between sickle cell anaemia and sickle HbC disorder patients, the results show that the undiscounted (discounted at 6 per cent ) lifetime treatment costs range from pound 92 323 (pound 24 917) to pound 185 614 (pound 53 861). The number of early deaths avoided per 100 births, as a result of early diagnosis through screening, ranges from 0.57 to 1.25. Conclusions The resulting estimates may act as a guide to those involved in the planning of health care provision with regard to the resources require d to treat sickle cell disorder patients. Such information may also be inco rporated into the evaluation of both antenatal and neonatal screening progr ammes for sickle cell disorders.