Cost-Effectiveness Analysis for Neonatal Hypothyroidism Screening: A Systematic Review

Neonatal hypothyroidism screening plays a crucial role in preventing irreversible neurological disorders causing developmental delays. Therefore, the policy decisions are needed based on context-appropriate cost-effectiveness analysis studies. Trend of evidence on cost-effectiveness is still dominated by studies from high-income countries. This evidence cannot be directly generalized to developing countries context such as Indonesia, which differ in health systems, financing, and access to services. In response to this issue, this study aims to analyze cost-effectiveness of using a systematic review approach of five studies following PRISMA-SR guidelines. This study systematically mapping threshold simulation analysis by evaluating the results of each study based on Indonesia's Willingness to Pay (WTP) and economic assumptions based on Indonesia's GDP per capita and health expenditure (upper-middle income classification) using the Umbrales Tool developed by Institute for Clinical Effectiveness and Health Policy (IECS). Although the included studies employed diverse economic models and perspectives, they consistently demonstrate that neonatal hypothyroidism screening significantly improves Quality-Adjusted Life Years (QALYs) and generates cost savings compared with managing undiagnosed cases. Thus, neonatal hypothyroidism screening is a feasible and highly beneficial intervention for implementation in Indonesia, as simulation results it is cost-effective.