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Clinical Chemistry 40: 1631-1636, 1994;
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Clinical Chemistry, Vol 40, 1631-1636, Copyright © 1994 by American Association for Clinical Chemistry

Cost-effectiveness analysis for evaluation of screening programs: hereditary hemochromatosis

GJ Buffone and JR Beck
Baylor College of Medicine, Houston, TX.

A significant body of research over the last 10-20 years supports the hypothesis that screening for hereditary hemochromatosis (HH) may be cost-effective, given the low-cost, low-risk therapeutic options available for most homozygous individuals. The factors that confound a straightforward test of this hypothesis include the fact that the disease is not fully penetrant and that, to achieve the anticipated life-year gains, therapy must be instituted before disease complications become irreversible. Recent articles and editorials, as well as practice guidelines prepared by the College of American Pathologists, recommend screening for HH with transferrin saturation and ferritin testing, and with percutaneous liver biopsy for those with positive laboratory test results. Patients at risk would be treated with phlebotomy for life and monitored with ferritin testing. We present a cost-effectiveness analysis that evaluates the efficacy of using a screening strategy to accomplish the desired healthcare goals.


The following articles in journals at HighWire Press have cited this article:


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W. H. Rogowski
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B. Schmitt, R. M. Golub, and R. Green
Screening Primary Care Patients for Hereditary Hemochromatosis with Transferrin Saturation and Serum Ferritin Level: Systematic Review for the American College of Physicians
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A. G. Mainous III, J. M. Gill, and W. S. Pearson
Should We Screen for Hemochromatosis?: An Examination of Evidence of Downstream Effects on Morbidity and Mortality
Arch Intern Med, August 12, 2002; 162(15): 1769 - 1774.
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A. C. Looker and C. L. Johnson
Prevalence of Elevated Serum Transferrin Saturation in Adults in the United States
Ann Intern Med, December 1, 1998; 129(11_Part_2): 940 - 945.
[Abstract] [Full Text]

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 ANN INTERN MEDHome page
S. M. McDonnell, P. D. Phatak, V. Felitti, A. Hover, and G. D. McLaren
Screening for Hemochromatosis in Primary Care Settings
Ann Intern Med, December 1, 1998; 129(11_Part_2): 962 - 970.
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M. E. Cogswell, S. M. McDonnell, M. J. Khoury, A. L. Franks, W. Burke, and G. Brittenham
Iron Overload, Public Health, and Genetics: Evaluating the Evidence for Hemochromatosis Screening
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Copyright © 1994 by the American Association for Clinical Chemistry.