Costs and Benefits of Prenatal Screening for Cystic Fibrosis

36 Pages Posted: 7 Apr 2004 Last revised: 30 Nov 2012

See all articles by Joseph P. Fenerty

Joseph P. Fenerty

Independent

Alan M. Garber

Stanford University - Center for Primary Care and Outcomes Research; Government of the United States of America - Palo Alto Veterans Affairs Medical Center; National Bureau of Economic Research (NBER)

Date Written: October 1988

Abstract

Newly-developed genetic tests based on restriction fragment length polymorphisms (RFLPs) promise to facilitate the early detection of genetic diseases. Several such tests are now available for the prenatal detection of cystic fibrosis (CF), a common and costly disease. The tests for CF are currently limited to prenatal diagnosis in siblings of a victim of CF. Direct gene probe tests, which have yet to be developed for CF, would be applicable even in families that have not already borne a child with the disease. We examine the costs and benefits of prenatal testing for cystic fibrosis using existing RFLP-based tests and using a hypothetical direct gene probe test. We find that even an expensive RAPbased testing program produces substantial net benefits, because it is applied in pregnancies in which the risk of CF is 25%. If a direct gene probe test is applied in all pregnancies, it will need to be much less expensive to generate net benefits, and it will lead to the abortion of many normal fetuses unless it is highly specific. Because these new tests are likely to generate substantial savings in medical expenditures and to increase lifetime earnings, parents of CF-affected children may be subjected to strong pressures to participate in prenatal testing programs and to abort fetuses that test positive. It is imperative that the ethical dilemmas arising from this promising screening test be discussed openly before it becomes widely available.

Suggested Citation

Fenerty, Joseph P. and Garber, Alan M., Costs and Benefits of Prenatal Screening for Cystic Fibrosis (October 1988). NBER Working Paper No. w2749. Available at SSRN: https://ssrn.com/abstract=447182

Joseph P. Fenerty

Independent

No Address Available

Alan M. Garber (Contact Author)

Stanford University - Center for Primary Care and Outcomes Research ( email )

179 Encina Commons
Stanford, CA 94305-6019
United States
650-723-0920 (Phone)
650-724-5182 (Fax)

Government of the United States of America - Palo Alto Veterans Affairs Medical Center

Palo Alto, CA 94304
United States

National Bureau of Economic Research (NBER)

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

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