Table 3.

One-way sensitivity analyses of the cost-effectiveness of introducing MCADD screening and of switching to MS/MS technology for PKU screening

Parameter	Value or range for sensitivity analyses	ICER (€/QALY)
Base-case values		7 581
MCADD birth prevalence	1/10 000 to 1/25 000	3 444 to 15 856
MCADD screening test specificity	0.9997 to 1	7 878 to 6 987
Risk of developing a metabolic crisis	0.75	5 881
Risk of death within 72 hours of life	0.05	5 902
Risk of death after a metabolic crisis	0.01 to 0.03	13 180 to 5 314
Risk of mild neurological sequelae	0	9 175
Risk of severe neurological sequelae	0	12 823
Screening effectiveness (reduction in the risk of developing a metabolic crisis)	0.5	14 351
Utility of persons unaffected by MCADD	0.9	8 769
Utility of persons with severe neurological sequelae	0.45	7 121
Utility of persons with mild neurological sequelae	0.92	7 632
Cost of the MCADD screening test (€)	3.38 to 5.16	5 384 to 15 655
Annual cost of management of severe	15 000 to 150 000	8 832 to −19 139*
Annual cost of management of mild neurological sequelae (€)	4 500 to 120 000	7 911 to −17 353*
Cost of treatment of a metabolic crisis	4 730	7 211
% patients receiving L-carnitine supplementation until 18 years of age	0% to 100%	6 617 to 8 546
Number of medical consultations per year until 6 years of age	5	7 667
	No discounting	−514*
Annual discounting rate	3% to 6%	4 954 to 13 598

* A negative cost-effectiveness ratio indicates that the strategy is both more effective and less costly than the comparison strategy.