In comparison with other New Zealand screening programmes and the levels at which PHARMAC might consider funding for a pharmaceutical, the proposed routine screening programme for PND within the Well Child framework appears to be highly cost-effective from a government perspective, when compared with current practice.
However, one must keep in mind that the economic study conducted herein is only intended to be an exploratory analysis and is based on a number of necessary assumptions, which represent ‘best estimates’ of current practice and the likely costs and benefits associated with the introduction of formalised screening. The economic analysis focuses on maternal outcomes and maternal health-related quality of life improvements. The model does not capture the impact of the successful treatment of PND to children and society in general. Importantly, the model does not capture likely future savings to other government jurisdictions such as education, social development and justice. Therefore, the ICER results from the exploratory model can be considered conservative. It is important to recognise that the value of any screening programme for PND will be dependent on the resources available locally and the ability of the woman and her primary care team to access these resources. Thus, screening for PND will only be effective if coupled with systems changes so that women can be appropriately diagnosed and treated. Many of the changes to practice needed to achieve better PNDrelated outcomes are currently not publicly funded to sufficient levels (e.g., support groups and psychologist sessions). Consequently, consideration may need to be given as to whether such costs should be funded by government if the proposed PND screening programme is to be effective at a national level.