An Economic Evaluation of Australia's Newborn Hearing Screening Program: A Within-Study Cost-Effectiveness Analysis.

The sample was small (137 children), and the utility confidence interval was wide (0.04 to 0.86). Utility data were missing for 27 (20%) children, Medicare Benefits Schedule data for 10 (7%), and Pharmaceutical Benefits Scheme data for 17 (12%). The analysis used utility measured at age 5 and applied it from birth to age 5, which may not represent younger ages. Only children diagnosed before three years of age were included, so late diagnoses were not captured. The study did not include costs beyond five years, education costs, hearing aid replacement, or long-term outcomes. Screening costs were not captured in SCOUT; universal screening costs were estimated from a Victorian program and targeted screening costs were assumed, then tested in scenarios. Only 83% of New South Wales children and 30% of Victorian children had received the respective screening, so some children were identified by carers or healthcare providers. The program context was immature, with mean hearing aid fitting at 13.5 months, later than the recommended six months. The cost-effectiveness result had high decision uncertainty: probability 69% at A$60,000 per QALY.

The authors declared no conflict of interest regarding publication. The supplied publication types indicate NIH extramural research support.

Do not read the A$48,000 per QALY estimate as proof that universal screening is clearly cost-effective or that it improves language. The estimate had a wide range, total costs were higher, and language outcomes were positive but not clear.