MedWire News: Mass screening for celiac disease can be a cost-effective strategy in young adults, Israeli researchers report.
The cost-effectiveness of screening was determined by the time delay between symptoms and diagnosis, quality of life on a gluten-free diet, and celiac disease prevalence.
There are many theoretical reasons for mass screening in celiac disease, say Eran Israeli (Hadassah-Hebrew University Medical Center, Jerusalem) and colleagues.
It is a common disorder that causes significant health problems and an effective treatment is available that results in symptomatic relief and prevents complications of the disease.
To examine whether mass screening is justified by its impact on quality of life and cost-effectiveness, the team developed a state transition Markov model that used information collected from previous studies of the disease.
Their model mass screening program targeted at individuals aged 18 years showed a gain in 0.0027 quality-adjusted life years (QALYs).
The incremental cost-effectiveness ratio of screening versus no screening was US$48,960 (€36,275) per QALY for a time delay of 6 years between symptom onset and a diagnosis of celiac disease.
Screening was cost-effective for a utility of adherence to a gluten-free diet greater than 0.978, and for a wide range of celiac disease prevalence from 0.87 to 2.00%.
The authors caution in the journal Alimentary Pharmacology and Therapeutics that mass screening would not be cost effective if the time between symptom initiation and diagnosis is less than 6 years.
“Thus, education of health professionals to increase awareness for celiac diseasediagnosis in symptomatic individuals, (thereby decreasing the time delay to diagnosis) may be a valid alternative to screening,” they say.
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