Table 3.
CEA for CAH-NBS in Brazil during the year of 2017.
| Decision model on a hypothetic population | Base case | Best case | Worst case |
|---|---|---|---|
| Yearly live-births (N) | 2,923,535 | 2,923,535 | 2,923,535 |
| Yearly CAH affected newborns (N) | 239 | 292 | 195 |
| SW newborns (N) | 179 | 219 | 146 |
| SV newborns (N) | 60 | 73 | 49 |
| SCREENING STRATEGY | |||
| SW form | |||
| Clinical recognition (N) | 64 | 35 | 80 |
| Costs (A + B) (US$) | 1,594.24 | 871.85 | 1,992.80 |
| Deaths (N) | 0 | 0 | 0 |
| Hospitalizations (N) | 0 | 0 | 0 |
| Total costs (US$) | 1,594.24 | 871.85 | 1,992.80 |
| No clinical recognition (N) | 115 | 184 | 66 |
| Costs (A + B) (US$) | 2,864.65 | 4,583.44 | 1,644.06 |
| Deaths (N) | 0 | 0 | 0 |
| Hospitalizations (N) | 67 | 107 | 38 |
| ICU (N) | 20 | 32 | 11 |
| ICU length (days) | 9 | 9 | 9 |
| Hospitalizations costs (US$) | 32,805.60 | 52,474.80 | 18,124.50 |
| Total costs (US$) | 35,670.25 | 57,058.24 | 19,768.56 |
| SV form | |||
| Costs (2A + B) (US$) | 1,641.60 | 1,997.28 | 1,340.64 |
| Deaths | 0 | 0 | 0 |
| Late adverse outcomes (N) | 0 | 0 | 0 |
| Total costs (US$) | 1,641.60 | 1,997.28 | 1,340.64 |
| Non-affected (N) | 2,923,296 | 2,923,243 | 2,923,340 |
| True negatives (N) | 2,917,449 | 2,920,320 | 2,908,723 |
| Costs (A) (US$) | 7,147,750.05 | 7,154,784.00 | 7,126,371.35 |
| False positives (N) | 5,847 | 2,923 | 14,617 |
| High risk (N) | 1,462 | 731 | 3,654 |
| Confirmatory true negative (N) | 1,345 | 673 | 3,362 |
| Costs (A + B) (US$) | 33,503.95 | 16,764.43 | 83,747.42 |
| Confirmatory false positive (N) | 117 | 58 | 292 |
| Costs (A + 2B) (US$) | 5,542.29 | 2,747.46 | 13,832.04 |
| Low risk (N) | 4,385 | 2,192 | 10,963 |
| Retest true negative (N) | 4,363 | 2,181 | 10,908 |
| Costs (2A) (US$) | 21,378.70 | 10,686.90 | 53,449.20 |
| Retest false positive (N) | 22 | 11 | 55 |
| Costs (2A + B) (US$) | 601.92 | 300.96 | 1,504.80 |
| Total cost of screening strategy (US$) | 7,247,683.00 | 7,245,211.12 | 7,302,006.81 |
| Deaths (N) | 0 | 0 | 0 |
| NON-SCREENING STRATEGY | |||
| SW form | |||
| Clinical recognition (N) | 64 | 35 | 80 |
| Deaths (N) | 0 | 0 | 0 |
| Hospitalizations (N) | 0 | 0 | 0 |
| Diagnostic lab (US$) | 963.20 | 526.75 | 1,204.00 |
| Total costs (US$) | 963.20 | 526.75 | 1,204.00 |
| No clinical recognition (N) | 115 | 184 | 66 |
| Deaths (N) | 9 | 20 | 3 |
| Hospitalizations (N) | 96 | 149 | 57 |
| ICU (N) | 35 | 54 | 21 |
| ICU length (days) | 23 | 23 | 23 |
| Hospitalization costs (US$) | 132,296.30 | 204,177.00 | 79,335.30 |
| Dehydration without hospitalization (cost of lab exams) (US$) | 150.05 | 225.75 | 90.30 |
| Total costs (US$) | 132,446.80 | 204,402.75 | 79,425.60 |
| SV form | |||
| Clinical recognition (N) | 17 | 8 | 22 |
| Costs with lab diagnostic (US$) | 255.85 | 120.40 | 331.10 |
| No clinical recognition (N) | 43 | 65 | 27 |
| Number of 46XX reared as males (N) | 3 | 5 | 2 |
| Masculinization process (US$) | 5,718.57 | 9,530.95 | 3,812.38 |
| Number of patients with GH treatment (N) | 6 | 9 | 4 |
| Use of GH cost (US$) | 117,047.03 | 175,570.55 | 78,031.35 |
| Number of patients with GnRh treatment (N) | 12 | 18 | 8 |
| Use of GnRha cost | 49,932.00 | 74,898.00 | 33,288.00 |
| Costs with lab diagnostic (US$) | 647.15 | 978.25 | 406.35 |
| Total costs (US$) | 174,160.23 | 260,977.75 | 115,538.08 |
| Total cost of non-screening strategy (US$) | 307,010.60 | 466,027.65 | 196,498.78 |
| Deaths (N) | 9 | 20 | 3 |
| Incremental cost of screening (US$) | 6,940,672.40 | 6,779,183.47 | 7,105,508.03 |
| Deaths averted (N) | 9 | 20 | 3 |
| Incremental cost per death averted (US$) | 771,185.82 | 338,959.17 | 2,368,502.68 |
| Incremental cost per life years saved (US$) | 25,535.95 | 11,223.81 | 78,427.24 |
SW, salt-wasting form; SV, simple virilizing form; LY, years of life saved; N, number; US$, American dollar.