College of Nursing, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Public Health Nurs. 2019 Jul;36(4):541-544. doi: 10.1111/phn.12614. Epub 2019 Apr 3.
Newborn screening (NBS) is a public health program that detects genetic conditions in neonates enabling treatment before clinical symptoms manifest. Severe combined immune deficiency (SCID) is a primary immune deficiency found in the absence of functioning T and B lymphocytes. Hematopoietic cell transplantation is a potentially curative treatment if received within the first 42 months of life; without treatment, this condition is fatal in the first 2 years of life due to severe opportunistic infections. SCID was added to the recommended uniform panel of conditions for inclusion in state NBS programs in 2010. This manuscript examines the societal costs and benefits of NBS for SCID in Arkansas and implications to health services and social welfare. Total cost per year of all NBS for SCID and resulting early treatment for one patient with SCID in Arkansas is estimated at $1,078,714. Cost of late treatment of one patient with SCID is estimated at $1.43 million. Based on an expected diagnosis of one patient per year in Arkansas, this results in an estimated net cost savings for NBS for SCID in Arkansas of $351,286 per year. Based on cost-effectiveness analysis, NBS for SCID in Arkansas is cost-effective, with higher societal benefit than cost.
新生儿筛查（NBS）是一项公共卫生计划，可在新生儿期检测遗传疾病，以便在临床症状出现之前进行治疗。严重联合免疫缺陷（SCID）是一种原发性免疫缺陷，表现为 T 和 B 淋巴细胞功能缺失。如果在生命的前 42 个月内接受造血细胞移植，这是一种潜在的治愈性治疗方法；如果不治疗，这种情况会因严重的机会性感染在生命的头 2 年内致命。2010 年，SCID 被添加到建议的州 NBS 计划统一条件清单中，以纳入条件清单。本文研究了阿肯色州 SCID 的 NBS 的社会效益和经济效益，以及对卫生服务和社会福利的影响。阿肯色州所有 SCID 新生儿筛查的年度总成本以及为一名 SCID 患者进行早期治疗的总成本估计为 1,078,714 美元。一名 SCID 患者晚期治疗的成本估计为 143 万美元。根据阿肯色州每年预计诊断出一名患者的情况，这将导致阿肯色州 SCID 的 NBS 每年节省估计净成本 351,286 美元。基于成本效益分析，阿肯色州的 SCID 的 NBS 具有成本效益，社会效益高于成本。
