Strategies for managing the costs of screening in newborn metabolic disorders: insights from a study in developing countries

Abstract Background Newborn metabolic screening (NMS) is crucial for early detection and intervention. However, the costs associated with screening programs can pose challenges, particularly in developing countries. Purpose This study aims to identify and prioritize strategies for managing the costs of NMS in a developing country context. Methods The study utilized the Time-Driven Activity-Based Costing (TDABC) method to assess the total cost of NMS programs (congenital hypothyroidism, PKU, G6PD) among 2030 newborns in Iran. Subsequently, experts were surveyed to identify and prioritize NMS program cost management strategies using the Delphi method and the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS). Data analysis was conducted using Expert_Choice11 and Excel 2017. Results The total cost of newborn screening per newborn was $4.7 for hypothyroidism, $4.8 for PKU, and $4.7 for G6PD. Human resources (HR) accounted for the highest total cost of hypothyroid, PKU, and G6PD NMS (77.7%, 76.6%, and 78.4%, respectively). The findings revealed several key strategies for cost management in NMS. The top-ranked strategies included preventing the preparation of inappropriate samples through training courses (TS: 0.988), creating incentives for sample quality (TS: 0.965), and implementing an integrated screening information system (TS: 0.961). Conclusion The results recommend implementing training courses and incentive programs to enhance sample quality in newborn metabolic screening. Additionally, redesigning healthcare facilities and integrating information systems can boost efficiency and reduce costs in developing countries. Future research should focus on long-term cost-effectiveness, comparative studies across regions, leveraging technology, understanding stakeholder perspectives, and evaluating policy impacts on newborn screening programs in developing countries.