Cost–Benefit and Effectiveness of Newborn Screening of Congenital Hypothyroidism: Findings from a National Program in Iran

SH Yarahmadi; SJ Tabibi; KH Alimohammadzadeh; E Ainy; MM Gooya; M Mojarrad; B Delgoshaei

International Journal of Endocrinology and Metabolism

Research Institute for Endocrine Sciences

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Cost–Benefit and Effectiveness of Newborn Screening of Congenital Hypothyroidism: Findings from a National Program in Iran

Author(s):

SH Yarahmadi¹,

SJ Tabibi²,

KH Alimohammadzadeh^2,*,

E Ainy³,

MM Gooya¹,

M Mojarrad⁴,

B Delgoshaei²

1Center for Disease Control, Ministry of Health and Medical Education, Tehran, IR.Iran

2Department of Health Services Management, Science and Research Branch , Islamic Azad University, Tehran, IR.Iran

3Safety Promotion and Injury Prevention Research Center, Tehran, IR.Iran

4Research Institute for Endocrine Sciences, Shaheed Beheshti University of Medical Sciences, Tehran, IR.Iran

International Journal of Endocrinology and Metabolism:Vol. 8, issue 1; e94632

Published online:Jan 31, 2009

Article type:Research Article

Received:May 29, 2019

Accepted:Jan 31, 2009

How to Cite:SH YarahmadiSJ TabibiKH AlimohammadzadehE AinyMM GooyaM MojarradB Delgoshaeiet al.Cost–Benefit and Effectiveness of Newborn Screening of Congenital Hypothyroidism: Findings from a National Program in Iran.Int J Endocrinol Metab.8(1):e94632.

Abstract

In this study, the cost-benefit of a screening program based on the rial, the unit of currency used, was analyzed. The intelligence quotient (IQ), and height and weight were evaluated as indices for a population of children suffering from congenital hypothyroidism (CH). Materials and Methods: The total cost for the screening program, including hormone tests, diagnosis, medicine, treatments and care was identified and calculated up to the age of seventy years and this was compared to the costs related to training and caring for patients suffering from mental retardation, who had not been screened. The screening test was done using S&S filter paper and thyroid stimulating hormone (TSH) was determined by the ELISA test.The future costs and benefits with an annual rate of 3% discount of their current value was estimated. To evaluate the effectiveness of the screening program, IQs of 32 patients were identified and compared to 36 healthy children between 2004-2005. The IQs were evaluated according to "Good Enough" and "Proteus Maze" tests. Results: During 2008, 1165169 of 12489136 newborns (51% male, 49% female) underwent screening for CH, 92% cover-age of all newborns for that year. Four percent of recalled infants, with TSH>5 were subjected to diagnostic tests (T4, TSH, T3RU) and finally 2745 patients were identified. Benefit to cost ratios, based on a 3% annual discount rate, were 22, 41, 32, 34, 47 and 60 times lower, respectively. No significant differences were found with regard to diferences in IQ scores between cases and controls (cases: 105±19.3, controls: 111±19.4), height (cases: 106±0.7, controls: 102±4.9 cm) and weight (cases: 15.6±4.6, control 15.3±3.2 kg). Conclusion: The national Newborn Screening (NBS) program for CH has been successful and quite effective in Iran. The method not only has economical advantages but also reduces capital expenditures and preserves normal IQ of the patients under treatment and prevents mental retardation and growth complications.

Keywords

Newborn screening

Congenital hypothyroidism

Cost-benefit

Mental retardation

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