Cost-Effectiveness Analysis of Different Prenatal Screening Strategies for the Prevention of Severe Thalassemia in Thailand
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Issued Date
2025-01-01
Resource Type
eISSN
11786981
Scopus ID
2-s2.0-105021970742
Journal Title
Clinicoeconomics and Outcomes Research
Volume
17
Start Page
835
End Page
848
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinicoeconomics and Outcomes Research Vol.17 (2025) , 835-848
Suggested Citation
Malasai K., Jittikoon J., Talungchit P., Youngkong S., Udomsinprasert W., Chaikledkaew U. Cost-Effectiveness Analysis of Different Prenatal Screening Strategies for the Prevention of Severe Thalassemia in Thailand. Clinicoeconomics and Outcomes Research Vol.17 (2025) , 835-848. 848. doi:10.2147/CEOR.S544493 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/113185
Title
Cost-Effectiveness Analysis of Different Prenatal Screening Strategies for the Prevention of Severe Thalassemia in Thailand
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Abstract
Purpose: Three prenatal screening protocols are currently used in Thailand to prevent severe thalassemia in newborns; however, economic evaluation data to guide the selection of the most cost-effective strategy remain limited. This study aimed to conduct the cost-effectiveness of these screening strategies to support policy and clinical decision-making. Patients and Methods: A decision-tree model was employed to evaluate the costs and outcomes associated with three prenatal screening algorithms: 1) a protocol starting with mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and the dichlorophenol indophenol precipitation (DCIP) test for pregnancies; 2) a protocol starting with MCV/MCH and hemoglobin (Hb) typing for pregnancies; and 3) a protocol starting with MCV/MCH and DCIP testing for couples based on a societal perspective. Results were presented as incremental cost-effectiveness ratios (ICERs) to compare the three prenatal screening strategies. Both one-way and probabilistic sensitivity analyses were performed to account for uncertainties in the parameters used. Results: From a societal perspective, Strategies 2 and 3 were found to be cost-effective compared to Strategy 1. Screening 10,000 couples under Strategies 2 and 3 could prevent 60 and 49 additional cases of severe thalassemia, respectively, compared to Strategy 1. The ICERs for Strategies 2 and 3 were approximately 141,863 Baht (4,023 United States Dollar, USD) and 97,996 Baht (2,779 USD) per severe thalassemia case prevented, respectively. The most sensitive parameter for comparing Strategy 2 with Strategy 1 was the specificity of prenatal diagnosis for α-thalassemia. Conclusion: Strategy 3 is the most cost-effective approach in Thailand. However, Strategy 2 may be implemented in hospitals with the capacity to perform Hb typing. These results offer significant value to policymakers by presenting strong evidence that could inform adjustments to the reimbursement framework in Thailand’s Universal Health Coverage benefit package, ultimately enhancing thalassemia management and prenatal care.