Economic evaluation of free newborn screening for congenital heart disease in Lishui City
YIN Chang1, YE Jiajia2, YANG Yongmei1
1. School of Medical Humanities and Management, Wenzhou Medical University, Wenzhou, Zhejiang 325025, China; 2. Lishui Maternal and Child Health Care Hospital, Lishui, Zhejiang 323000, China
Abstract：Objective To evaluate the health economic value of the free screening policy for congenital heart disease (CHD) among newborns in Lishui City, Zhejiang Province, so as to provide the evidence for optimizing health resource allocation and improving basic public health services. Methods Data on free CHD screening in Lishui City from 2022 to 2024 were collected through the Newborn CHD Screening Registration System of Lishui Maternity and Child Health Care Hospital. With no screening as the control, costs, benefits and utilities were calculated and discounted to the year 2022 at a discount rate of 3%. Benefit-cost ratio (BCR) and incremental cost-utility ratio (ICUR) were used for economic evaluation. One-way sensitivity analysis and Monte Carlo probabilistic sensitivity analysis were conducte. Results A total of 44 343 newborns were screened for free CHD in Lishui City from 2022 to 2024. Among them, 4 202 tested positive on initial screening, 367 were confirmed as CHD cases, and 3 835 were false-positive. After discounting, the total screening cost was 2.141 0 million yuan, with total benefits of 13.148 2 million yuan and the net health utility gain was 245.32 quality-adjusted life year (QALY). The BCR was 6.14, and the ICUR was 8 727 yuan/QALY, which was lower than the willingness-to-pay threshold of per capita gross domestic product in Lishui City (78 978 yuan/QALY). Sensitivity analysis showed that the BCR remained above 1 and the ICUR remained below the willingness-to-pay threshold across all key parameters, indicating robust results. Conclusions The free newborn CHD screening policy in Lishui City presents favorable economic efficiency and scalability. It is recommended to further optimize costs and benefits through centralized procurement of consumables and closed-loop information management.
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