Presentation March 17th 2016

Making the case for SCID screening in France

Summary

Including SCID in newborn screening across Europe is currently under debate. In making a case for inclusion in France, Dr. Isabelle Durand-Zaleski explored the costs incurred versus those saved by early management. She initiated a micro costing study to document the resources used during a pilot study involving dried blood spot cards and a molecular quantification method.

In order to assess the treatment costs, the data from SCID patients admitted to the national reference center for primary immunodeficiency, between 2006 and 2010, was used to estimate the costs for patients who underwent early versus delayed hematopoietic stem cell transplantation (HSCT) age, <3 vs >3 months). The unit cost of the test varied between €4.69 and €6.79 for 33,800 samples per year, depending on equipment used and the volume of samples run. 

Of the 30 patients included, 27 underwent HSCT after three months. Ten of these patients died while all three patients undergoing early transplantation survived. The medical costs for HSCT performed after three months of age was €195,776 (interquartile range, €165,884-€257,160) versus €86,179 (range, €59,014-€272,577) when performed before three months of age. In patients undergoing late transplantation, active infection contributed to higher costs and poorer outcomes.

Study results indicate that early detection of SCID could reduce the cost of treatment by €50,000-100,000 per case. Assuming a €5 unit cost per test, the incidence required to break even is 1:20,000; indicating universal screening is cost-effective.

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