Birth Defect Costs Set at $8 Billion : Health: Researchers estimate toll of long-term care for U.S. children born with most common problems. Data points to need for study on causes and prevention.
Researchers, estimating for the first time the costs of long-term medical care for children born with some of the most common birth defects, have calculated a price tag of more than $8 billion--a significant fraction of national health care costs.
Using data from the California Birth Defects Monitoring Program, economist Norman J. Waitzman of the University of Utah and his California colleagues examined the lifetime costs for U.S. children born each year with 18 common birth defects.
The defects cover a broad range of congenital problems, including hernias, cerebral palsy, cleft lips and palates, and spina bifida. But such infants represent only 22% of the 120,000 children born with birth defects each year, so the overall costs are substantially higher than $8 billion, the researchers reported Thursday in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.
“We don’t know how big the total costs are,” said Dr. John Harris, director of the monitoring program. “These costs we are reporting are just the tip of the iceberg. And the costs just keep recurring every year as new babies are born with the defects.”
Findings such as these are particularly important, according to experts, because they demonstrate the magnitude of the problem and the need for research on causes and prevention strategies.
“The bottom line is money spent today to find causes is a smart investment which will ultimately save millions of dollars,” said Kim Belshe, director of the California Department of Health Services.
Dr. Jennifer Howse, president of the March of Dimes Birth Defects Foundation, said: “The true costs are probably much larger. And you can’t put a price tag on the grief of the family and the diminished quality of life for the victims.”
Most people are well aware of the human costs of birth defects, said epidemiologist Tom Sinks of the birth defects division of the CDC, “but it is important to understand that there are economic costs as well.” Cost compilations such as this one “give us a good reason to do more research and surveillance to identify workable preventions to decrease the human and economic burdens of birth defects.”
Similar studies have not been attempted before, said Michelle Kling, a spokeswoman for the March of Dimes, because there has not been a large enough database on birth defects and their costs.
The California monitoring program, established in 1982, is one of the few state programs that produces an accurate record of numbers and types of birth defects, and the large number of births in the state--300,000 each year--provides confidence that the statistics are accurate. On average, about one in every 33 infants suffers from some sort of birth defect. One-third of all infant mortality is caused by birth defects.
The program had previously issued similar numbers on the cost of birth defects in California. Now they have extrapolated those costs to the country as a whole, using appropriate modifications for the lower costs of medical care in other states.
For each birth defect, the researchers added the average direct medical costs, other direct costs, such as developmental services and special education, and such indirect costs as lost productivity due to early death or occupational limitations. They did not include other indirect costs such as the lost wages of parents caring for the children.
“The average cost associated with each infant born with many of these conditions is remarkably high--among the highest I have encountered in cost-of-illness studies,” Waitzman said.
“Much of this cost is borne by the community through higher medical insurance premiums and tax dollars spent on treatment and special services,” Waitzman said. “Particularly in these times of fiscal squeeze, these costs provide a vivid picture of the value of research and prevention.”
Among the most costly of the congenital problems is cerebral palsy. Average lifetime costs for each victim are an estimated $503,000; the total lifetime costs for the estimated 4,822 cerebral palsy victims born in any one year are $2.4 billion. Similarly, the average cost for a Down’s syndrome patient is $451,000, with a nationwide total of nearly $1.9 billion for all babies born with the syndrome each year.
Sadly, only two of the birth defects on the list are considered at least partially preventable--spina bifida and cleft lips and palates. The number of cases of spina bifida, which costs $489 million for children born in one year, could be reduced by half if women took supplements of folic acid. Similarly, at least a quarter of the cases of cleft lips and palates, which cost $696 million, could be reduced if women took multivitamin supplements during pregnancy.
The cost data, Harris said, “argues strongly for the need to invest in research to find causes. It has to be a national priority” because of the high human and economic costs.
And according to the monitoring program’s data, he noted, the risk of having a child with birth defects cuts across all barriers of class, race and geography. “The risk is about the same no matter who you are,” Harris said.
