Alotaibi Amal F, Almalki Rami A, Alsheikh Mona Y, Omran Ghufran O, Althobaiti Hana A, AlQurashi Wejdan S
Pharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia.
Pharmaceutical Care Department, King Faisal Hospital, Makkah Healthcare Cluster, Makkah 24382, Saudi Arabia.
Healthcare (Basel). 2025 Sep 8;13(17):2243. doi: 10.3390/healthcare13172243.
In Saudi Arabia, the government has implemented compulsory premarital screening and consultations for high-risk and positive sickle cell results (traits = AS gene and disease = SS gene). However, despite these measures being in place since 2004, there are still cases of children being born with sickle cell disease. This study aims to evaluate the costs associated with the government's mandatory premarital screening for sickle cell anemia, compare these expenses with those incurred due to high-risk marriages and analyze the government's healthcare spending on sickle cell anemia management. A decision tree model was conceptualized for the purpose of this study to identify the possible paths from the premarital screening (PMS) procedure. A total of 300,000 cases were processed through this decision tree model. The annual management costs for children with the probability of having sickle cell disease are estimated to be USD 10,746,450 in the screening arm and USD 40,488,000 in the no-screening arm. These costs vary depending on the genetic combination of the parents. For individuals with the SS/SS gene combination, the estimated cost is USD 8,137,800 per year. When parents have the SS/AS gene combination, the estimated cost is USD 2,071,950 annually. For those with the sickle cell trait combination (AS/AS), the cost is estimated to be USD 536,700 per year. A direct comparison shows a modeled PMS incremental cost is estimated at USD 29,741,550, which is approximately a 73% reduction in healthcare costs. The premarital screening for sickle cell disease is not only cost-saving but also shows the potential for significantly reducing healthcare spending related to sickle cell disease in the future.
在沙特阿拉伯，政府已针对高危和镰状细胞检测结果呈阳性（性状 = AS 基因，疾病 = SS 基因）的情况实施了强制婚前筛查和咨询。然而，尽管这些措施自 20044 年就已实施，但仍有儿童患有镰状细胞病的病例。本研究旨在评估政府对镰状细胞贫血进行强制婚前筛查的相关成本，将这些费用与高危婚姻产生的费用进行比较，并分析政府在镰状细胞贫血管理方面的医疗支出。为了本研究的目的，构建了一个决策树模型，以确定婚前筛查（PMS）程序可能的路径。通过这个决策树模型总共处理了 300,000 个案例。估计筛查组中可能患有镰状细胞病的儿童的年度管理成本为 10,746,450 美元，未筛查组为 40,488,000 美元。这些成本因父母的基因组合而异。对于 SS/SS 基因组合的个体，估计每年成本为 8,137,800 美元。当父母为 SS/AS 基因组合时，估计每年成本为 2,071,950 美元。对于具有镰状细胞性状组合（AS/AS）的个体，估计每年成本为 536,700 美元。直接比较显示，建模的 PMS 增量成本估计为 29,741,550 美元，这大约使医疗成本降低了 73%。镰状细胞病的婚前筛查不仅节省成本，而且显示出未来有可能显著降低与镰状细胞病相关的医疗支出。
