CostComparison ofMolecular versusConventional Screening ofRelatives atRiskforRetinoblastoma

Summary Tocompare costs ofmolecular andconventional screeningofretinoblastoma relatives, weevaluated thedirect health care costs. Withvariables setatthemostlikely values (baseline), theexpected cost (in1994Canadian dollars) ofconventional screening was$31,430 fora prototype family consisting ofseven at-risk relatives (three clinic exams andeight examinations under anaesthetic over thefirst 3years oflife foreachrelative). For themolecular strategy that involves looking fortheRB1 genemutation intheproband, testing therelatives for that mutation, andclinical follow-up similar toconventional strategy forrelatives with mutation, theexpected costwas$8,674, using baseline variables. Sensitivity analysis overtherange ofvalues foreachvariable revealed asignificant saving ofhealth care dollars bythe molecular route, indicating thebenefit ofredirecting economic resources tomolecular diagnosis inretinoblastoma.