Cost-effectiveness of genetic-based screening strategies for maturity-onset diabetes of the young.
Kovács G., Nagy D., Szilberhorn L., Zelei T., Gaál Z., Vellekoop H., Huygens S., Versteegh M., Mölken MR-V., Koleva-Kolarova R., Tsiachristas A., Wordsworth S., Nagy B.
Maturity-onset diabetes of the young (MODY) is often misdiagnosed as Type I or II diabetes. This study was designed to assess the cost-effectiveness of MODY screening strategies in Hungary, which included a recent genetic test compared with no routine screening for MODY. A simulation model that combined a decision tree and an individual-level Markov model was constructed to assess the costs per quality-adjusted life year of screening strategies. Stratifying patients based on age and insulin treatment followed by a risk assessment questionnaire, a laboratory test and genetic testing was the most cost-effective strategy, saving EUR 12 and generating 0.0047 quality-adjusted life years gained per screened patient. This screening strategy could be considered for reimbursement, especially in countries with limited resources.