Prenatal cystic fibrosis screening in Mexican Americans: An economic analysis

OBJECTIVE: We evaluated the cost benefit of cystic fibrosis screening in Mexican American gravid women. STUDY DESIGN: With the use of decisions analysis techniques, a cost-benefit analysis was performed. Baseline assumptions were based on published references. Sensitivity analyses were performed. RESULTS: Under the baseline assumptions, screening was not cost beneficial. Threshold analysis showed that, if the test was priced under $53.00, screening became cost beneficial. Sensitivity analysis demonstrated that lower acceptance rates of amniocentesis or termination made the screening strategy less attractive. If the test sensitivity was raised to 90%, which required testing of >60 mutations, the cost of screening would need to be <$100.00 for the program to be cost beneficial. CONCLUSION: Cystic fibrosis screening is not cost beneficial in Mexican American women over a wide range of assumptions. This is principally due to the poor sensitivity of the test in this population. Cultural factors, such as lower acceptance of amniocentesis and pregnancy termination of affected fetuses, further lower the cost-benefit ratio of screening.