A new outcome measure for cost-utility analyses of screening programs

Resumen

In this paper we provide a new outcome measure for the cost-utility analyses of alternative screening programs of a particular disease. We show that for non-invasive screening programs satisfying plausible assumptions, QALYs can be replaced by a simpler outcome: the sensitivity of the program. In other words, the cost-utility analysis can be made without computing the utility each program offers. Consequently, results would be immune to two of the most controversial issues in the cost-utility analysis approach: the elicitation method to obtain quality weights of health profiles, and the discount rate for future health benefits. The assumptions are particularly suitable in the case of selecting between the universal and the selective implementation of a non-invasive screening program. Therefore, we apply our result to provide an additional viewpoint in the current debate about the implementation of a universal or selective newborn screening program to detect congenital hearing impairment.