Standard care for FASD typically focuses on individualized symptoms management and evidence suggests that early intervention can be beneficial. In addition to significant impacts to patients’ wellbeing, the annual economic burden of FASD to society is large and was estimated to be $1.9 billion in 2017 Canadian Dollars. Evidence suggests that this population experiences lower rates of academic achievement, higher rates of incarceration, increased risk of problematic substance use, and higher overall mortality than the general public. The prevalence of FASD in Canada is estimated to be between 2 and 3% and individuals impacted by FASD often face substantial burden. Common symptoms associated with FASD include facial dysmorphia, stunted growth, abnormal neurodevelopment, behavioral issues, and impairments to cognitive function. Since diagnosis can be key to children receiving timely and appropriate health and educational services, cost-savings must be weighed against the fewer years of life with a diagnosis associated with screening.įetal Alcohol Spectrum Disorder (FASD) is characterized by physical and neurological abnormalities that result from prenatal exposure to alcohol. Conclusionįindings suggest that screening is associated with less use of healthcare recourses but also fewer years of life with an FASD diagnosis over a no screening strategy. Screening children with the NST resulted in a reduced cost of $183,895 per 100 individuals screened and 77 fewer diagnosed years of life by age 18, corresponding to an ICER of $2390. The model predicts that screening newborns with meconium testing results in a reduced cost of $89,186 per 100 individuals screened and 38 fewer diagnosed years of life by age 18, corresponding to an incremental cost-effectiveness ratio (ICER) of $2359. Resultsīoth screening tools evaluated resulted in reduced costs and fewer diagnosed years of life than a no screening strategy in which all children suspected of FASD receive diagnostic testing. Costs reflect 2017 Canadian dollars and the perspective is the public healthcare system. One-way and probabilistic sensitivity analyses were conducted to assess the robustness of findings. An economic model was constructed to assess cost-effectiveness. The screenings tools evaluated were chosen from Children’s Healthcare Canada’s National Screening Toolkit for Children and Youth Identified and Potentially Affected by FASD and include meconium testing of fatty acid ethyl esters (meconium testing) and the neurobehavioral screening tool (NST). The present study set out to assess the cost-effectiveness of currently recommended FASD screening tools. Subsequently, screening children suspected of FASD prior to diagnostic testing has been suggested, to avoid administering testing to children who are unlikely to receive a diagnosis. Though diagnosis may help improve patient outcomes, the diagnostic process can be costly. Fetal Alcohol Spectrum Disorder (FASD) is characterized by physical and neurological abnormalities resulting from prenatal alcohol exposure.
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