the cost effectiveness of newborn hearing screening program: new approach of iran ministry of health and medical education in 2022

Background: in iran’s newborn hearing screening (nhs) program, oae and aabr are administered to early identify hearing impairment in the primary health care (phc) system. objectives: the aim of this study was to conduct a cost-effectiveness analysis of this program integrated into iran's health system. methods: we examined the cost-effectiveness of aabr and oae screening procedures in infants less than 1 month old. treeage 2022 software was used for cost-effective modeling. in this study, qol and qaly were considered as the outcome measures. to evaluate the robustness of the modeling results, we used one-way sensitivity analysis. a ± 20% variation was utilized to determine target variables and estimate the costs per identification. results: in 2022, a total of 1,106,072 babies were born in iran, of whom 1,006,293 underwent hearing impairment screening (coverage rate: 90.97%). overall, 3,359 of the newborns screened were diagnosed with hearing problems, indicating a mean prevalence of 3.3 per 1000 births. the icer was equal to 3297.2 us ppp (purchasing power parity) per qaly. according to our results, the dominant cost-effective strategy for hearing impairment screening was oae plus aabr. after 1000 iterations, the second cost-effective strategy was found to be oae alone, according to monte carlo simulation modeling. conclusions: in this study, we evaluated the cost-effectiveness of the nhs program for detecting hearing impairment in over a million births in iran. a two-step screening approach, including oae and aabr, was found to be the dominant cost-effective strategy to identify newborns with hearing impairment.