Journal Article

Will Genetic Testing Alter the Management of Disease Caused by Infectious Agents? A Cost-Effectiveness Analysis of Gene-Testing Strategies for Prevention of Rheumatic Fever

Charles H. King, Diana F. Fischler and Richard D. Gerkin

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 11, pages 1491-1499
Published in print June 2002 | ISSN: 1058-4838
Published online June 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/340341
Will Genetic Testing Alter the Management of Disease Caused by Infectious Agents? A Cost-Effectiveness Analysis of Gene-Testing Strategies for Prevention of Rheumatic Fever

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Cost-effectiveness analysis was done to evaluate the potential health and economic effects of a genetic screening program to identify individuals at risk for rheumatic fever (RF). The current RF prevention strategy was compared with a new, primary prevention strategy involving early genetic testing and intensive prophylaxis to prevent a first attack among individuals at high risk for RF. When analysis of a hypothetical 2000 birth cohort was done from a societal perspective, the prevention strategy involving genetic screening and prophylaxis for high-risk persons reduced the number of RF cases and increased life span at an estimated discounted cost of $7900 per quality-adjusted life-year gained. Genetic screening became the preferred (least expensive) strategy if the test specificity was ⩾98%, the annual cost of prophylaxis was <$550, or the annual cost of caring for an individual with severe rheumatic heart disease increased to ã$32,000. When used with available antibiotic prophylaxis, genetic testing has the potential to provide a cost-effective strategy for the primary prevention of RF and its sequelae.

Journal Article.  5311 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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