January 11, 1980

Congenital Hypothyroidism Control Programs-Reply

Author Affiliations

Center for Disease Control Atlanta

JAMA. 1980;243(2):119-120. doi:10.1001/jama.1980.03300280017012

In Reply.—  We agree with Dr Schenken that the total costs of screening programs are difficult to evaluate; therefore, we wish to clarify the methods we used in our economic analysis of congenital hypothyroidism control programs. We broke down the cost of screening into two main components: specimen collection and laboratory costs. Our estimate of the cost of specimen collection was based on a 1973 study of the phenylketonuria (PKU) screening program in Massachusetts,1 as similar specimens are required for PKU and congenital hypothyroidism testing. Personnel time needed to obtain the blood and process laboratory forms was included, as well as the expense of mailing the specimen to the central state laboratory. Also considered were the costs of repeated specimen collection, including the physician's fee for a special office visit, for infants whose initial test result indicated that further evaluation was warranted.We increased the cost per specimen by 36%