Preconceptionele screening van paren op dragerschap van cystische fibrose in Nederland: kosten en besparingen

To evaluate effects, costs and savings for a preconceptional couple screening programme for cystic fibrosis (CF) carriers.

Setting

State University Groningen, the Netherlands.

Design

Prospective theoretical evaluation.

Method

A decision tree and an arithmetic model were constructed for two different strategies of preconceptional CF screening of couples: ‘single entry two step’ (SETS; start by testing one partner), and ‘double entry two step’ (DETS; test both partners). The difference between costs of screening and costs of CF illness prevented by screening was determined.

Results

DETS couple screening with the assumptions used for e.g. sensitivity and use of options can detect 81.5 of carrier couples in the Netherlands (against 70 for SETS), but results in twice as many positive/negative couples as SETS couple screening. The maximum number of carrier couples identified when screening 100,000 couples would be 88, resulting in a decrease of the number of children with CF of 25 each year. The costs of screening equal the savings if approximately 8,000 couples are screened yearly in the Netherlands.

Conclusions

There are no financial objections to preconceptional couple screening in the Netherlands, even with an uptake ratio of around 10. Whether screening for CF carriers should be offered or not should be decided on the basis of non-financial arguments.