International perspectives on the cost-effectiveness of tandem mass spectrometry for rare metabolic conditions

Publication Type:
Journal Article
Health Policy, 2009, 89 (3), pp. 252 - 260
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Objectives: To examine and evaluate the economic evidence regarding the use of tandem mass spectrometry (MS/MS) for the detection of rare metabolic conditions in neonates, and then to consider the transferability of these national-level results to other decision-making contexts. Methods: A systematic literature review was undertaken, identifying papers published between January 1997 and March 2008. Thirteen unique cost-effectiveness evaluations were identified and appraised for comparability and transferability of results across settings. Results: The primary outcome measure was usually life years gained (LYG) or quality-adjusted life years gained (QALY). The incremental cost-effectiveness ratios (ICER) presented were generally supportive of MS/MS, but showed considerable variation. Differences in assumptions made regarding prevalence and prognosis played a significant role in this variation. Conclusions: Differences in study structure, the approach to costing, the choice of intervention, control and outcome measure, and the limit of studies to developed countries makes international generalisation of the cost-effectiveness evidence difficult. The importance of assumptions regarding disease progression and subsequent health care utilisation suggests that further work needs to consider the importance of longer-term follow-up. © 2008 Elsevier Ireland Ltd. All rights reserved.
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