FETAL ALCOHOL SPECTRUM DISORDER: COST OF SCREENING AND DIAGNOSIS IN CANADA

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Abstract

Introductions

Prenatal alcohol exposure can lead to a myriad of adverse health outcomes for the child, including Fetal Alcohol Spectrum Disorder (FASD). Unfortunately, for a number of reasons, FASD is underdiagnosed in many countries, including Canada. The diagnosis of FASD is not simple and is a time consuming process that should be done via a comprehensive, multidisciplinary assessment of the individual.

Objectives

To estimate the per person and the annual cost of FASD screening diagnostic services in Canada.

Methods

The breakdown of the diagnostic process was based on the Fetal Alcohol Spectrum Disorder: Canadian Guidelines for Diagnosis. In order to calculate the per person cost of diagnosis, the number of hours required by each specialist involved in the diagnostic process were estimated, and the average rate per hour for each specialist was applied to the respective number of hours needed. The existing clinical capacity of all FASD multidisciplinary clinics in Canada, obtained from the 2005 and 2011 surveys conducted by the Canada Northwest FASD Research Network, was used to estimate the number of FASD cases diagnosed per year in Canada. The per person cost of FASD diagnosis was applied to the total number of FASD cases diagnosed per year in Canada in order to calculate the annual cost of FASD diagnostic services in Canada.

Results

It was estimated that a comprehensive, multidisciplinary FASD assessment requires 32 to 47 hours, resulting in a total cost of $3,110 to $4,570 per person. Based on a clinical capacity of 2,288 in Canada per year, and assuming that 50% (lower estimate) to 70% (upper estimate) of all individuals evaluated are diagnosed with FASD, it was calculated that 1,602 to 1,144 cases of FASD are diagnosed per year in Canada. As such, it was estimated that the cost of all FASD screening and diagnostic services in Canada ranges from $3.6 to $5.2 million (lower estimate), up to $5.0 to $7.3 million (upper estimate) per year.

Conclusions

Cost of FASD screening and diagnostic services is high in Canada. However, this economic burden is largely avoidable given that FASD is preventable if effective policies are implemented.

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