Tools
Tools
Ayres, Alice C., Whitty, Jennifer A. 
ORCID: https://orcid.org/0000-0002-5886-1933 and Ellwood, David A.
(2014)
A cost-effectiveness analysis comparing different strategies to implement noninvasive prenatal testing into a Down syndrome screening program.
The Australian and New Zealand Journal of Obstetrics and Gynaecology, 54 (5).
pp. 412-417.
ISSN 0004-8666
Abstract
Background Currently, noninvasive prenatal testing (NIPT) is only recommended in high-risk women following conventional Down syndrome (DS) screening, and it has not yet been included in the Australian DS screening program. Aims To evaluate the cost-effectiveness of different strategies of NIPT for DS screening in comparison with current practice. Methods A decision-analytic approach modelled a theoretical cohort of 300,000 singleton pregnancies. The strategies compared were the following: current practice, NIPT as a second-tier investigation, NIPT only in women >35 years, NIPT only in women >40 years and NIPT for all women. The direct costs (low and high estimates) were derived using both health system costs and patient out-of-pocket expenses. The number of DS cases detected and procedure-related losses (PRL) were compared between strategies. The incremental cost per case detected was the primary measure of cost-effectiveness. Results Universal NIPT costs an additional $134,636,832 compared with current practice, but detects 123 more DS cases (at an incremental cost of $1,094,608 per case) and avoids 90 PRL. NIPT for women >40 years was the most cost-effective strategy, costing an incremental $81,199 per additional DS case detected and avoiding 95 PRL. Conclusions The cost of NIPT needs to decrease significantly if it is to replace current practice on a purely cost-effectiveness basis. However, it may be beneficial to use NIPT as first-line screening in selected high-risk patients. Further evaluation is needed to consider the longer-term costs and benefits of screening.
| Item Type: | Article |
|---|---|
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Health Economics Faculty of Medicine and Health Sciences > Research Groups > Respiratory and Airways Group Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) |
| Related URLs: | |
| Depositing User: | Pure Connector |
| Date Deposited: | 27 Apr 2016 10:00 |
| Last Modified: | 22 Oct 2022 01:04 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/58405 |
| DOI: | 10.1111/ajo.2014.54.issue-5 |
Actions (login required)
 |
View Item |