Economic evaluation of long-term impacts of universal newborn hearing screening.

OBJECTIVE

Little is known about the long-term efficacious and economic impacts of universal newborn hearing screening (UNHS).

DESIGN

An analytical Markov decision model was framed with two screening strategies: UNHS with transient evoked otoacoustic emission (TEOAE) test and automatic acoustic brainstem response (aABR) test against no screening. By estimating intervention and long-term costs on treatment and productivity losses and the utility of life years determined by the status of hearing loss, we computed base-case estimates of the incremental cost-utility ratios (ICURs). The scattered plot of ICUR and acceptability curve was used to assess the economic results of aABR versus TEOAE or both versus no screening.

STUDY SAMPLE: A hypothetical cohort of 200,000 Taiwanese newborns.

RESULTS

TEOAE and aABR dominated over no screening strategy (ICUR = $-4800.89 and $-4111.23, indicating less cost and more utility). Given $20,000 of willingness to pay (WTP), the probability of being cost-effective of aABR against TEOAE was up to 90%.

CONCLUSIONS

UNHS for hearing loss with aABR is the most economic option and supported by economically evidence-based evaluation from societal perspective.