Noninvasive Prenatal Testing for Trisomies 21, 18, and 13, Sex Chromosome Aneuploidies, and Microdeletions in Average-Risk Pregnancies: A Cost-Effectiveness Analysis

Xie, Xuanqian; Wang, Myra; Goh, Elaine Suk-Ying; Ungar, Wendy J.; Little, Julian; Carroll, June C.; Okun, Nan; Huang, Tianhua; Rousseau, François; Dougan, Shelley; Tu, Hong; Higgins, Caroline; Holubowich, Corinne; Sikich, Nancy; Dhalla, Irfan A.; Ng, Vivian

doi:10.1016/j.jogc.2019.12.007

Cited by 15 publications

(11 citation statements)

References 12 publications

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“…The parameters used in this model were rational and could represent general situations in China according to pure theoretical or population-based analysis ( 42 , 43 ). Since the incidence of T21 in AMA was similar to high risk in the general population identified by serum screening ( 30 , 44 ), the advantage of contingent NIPT in the current study was consistent with the previous studies ( 8 , 19 – 22 , 43 , 45 – 47 ), from unnecessary invasive procedure reduction to total costs, as well as the cost-effect analysis. At a similar cut-off value, contingent NIPT after TTSS was much cheaper with considerable screening efficiency than direct invasive testing in an age-based strategy ( 15 ).…”

Section: Discussionsupporting

confidence: 89%

A Cost-Effectiveness Analysis of Screening Strategies Involving Non-Invasive Prenatal Testing for Trisomy 21

Wang

Liu

Yang

et al. 2022

Front. Public Health

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IntroductionIn accordance with social development, the proportion of advanced maternal age (AMA) increased and the cost of non-invasive prenatal testing (NIPT) decreased.ObjectiveWe aimed to investigate the benefits and cost-effectiveness of NIPT as primary or contingent strategies limited to the high-risk population of trisomy 21 (T21).MethodsReferring to parameters from publications or on-site verification, a theoretical model involving 1,000,000 single pregnancies was established. We presented five screening scenarios, primary NIPT (Strategy 1), contingent NIPT after traditional triple serum screening higher than 1/300 or 1/1,000 (Strategy 2-1 or 2-2), and age-based Strategy 3. Strategy 3 was stratified, with the following options: (1) for advanced maternal age (AMA) of 40 years and more, diagnostic testing was offered, (2) for AMA of 35–39 years, NIPT was introduced, (3) if younger than 35 years of age, contingent NIPT with risk higher than 1:300 (Strategy 3-1) or 1:1,000 (Strategy 3-2) will be offered. The primary outcome was an incremental cost analysis on the baseline and alternative assumptions, taking aging society, NIPT price, and compliance into consideration. The strategy was “appropriate” when the incremental cost was less than the cost of raising one T21 child (0.215 million US$). The second outcome included total cost, cost-effect, cost-benefit analysis, and screening efficiency.ResultsStrategy1 was costly, while detecting most T21. Strategy 2-1 reduced unnecessary prenatal diagnosis (PD) and was optimal in total cost, cost-effect, and cost-benefit analysis, nevertheless, T21 detection was the least. Strategy 3 induced most of the PD procedures. Then, setting Strategy2-1 as a baseline for incremental cost analysis, Strategy 3-1 was appropriate. In sensitivity analysis, when the NIPT price was lower than 47 US$, Strategy 1 was the most appropriate. In a society with more than 20% of people older than 35 years of age, the incremental cost of Strategy 3-2 was proper.ConclusionCombined strategies involving NIPT reduced unnecessary diagnostic tests. The AMA proportion and NIPT price played critical roles in the strategic decision. The age-based strategy was optimal in incremental cost analysis and was presented to be prominent as AMA proportion and NIPT acceptance increased. The primary NIPT was the most effective, but only at a certain price, it became the most cost-effective strategy.

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Section: Discussionsupporting

confidence: 89%

A Cost-Effectiveness Analysis of Screening Strategies Involving Non-Invasive Prenatal Testing for Trisomy 21

Wang

Liu

Yang

et al. 2022

Front. Public Health

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“…Yet, in many health care jurisdictions, an economic evaluation is an important step and has to be performed before considering expanding the conditions listed in a NIPTbased screening program. A current study showed that adding SCAs in a first-tier NIPT-based program increased the screening cost (Xie et al, 2020). However, due to the low external validity of the economic evaluation, economic evaluations should be performed in every health care jurisdiction.…”

Section: Interpretation Of the Findingsmentioning

confidence: 89%

Non‐invasive prenatal testing for the prenatal screening of sex chromosome aneuploidies: A systematic review and meta‐analysis of diagnostic test accuracy studies

Soukkhaphone

Lindsay

Langlois

et al. 2021

Molec Gen & Gen Med

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“…Таблица 3. Показатели медико-экономической эффективности в исследовании X. Xie et al [11] Внедрение НИПТ в качестве теста второй линии снижало затраты на 1,6%, или на 80 432 долл., по сравнению с существующим подходом скрининга беременных женщин. Такой результат объясняется более высокими ценами на ИПД (в среднем 864 канад.…”

Section: австралияunclassified

Non-Invasive Prenatal Testing: the International Experience of Medical and Economic NIPT Efficiency Evaluation

Kaplanova¹,

Galaktionova²,

Баранова

et al. 2022

Annals RAMS

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Non-invasive prenatal testing (NIPT) is a molecular genetic method of cell-free fetal DNA fetal chromosomal abnormalities risks assessing. Currently, NIPT is quite widespread throughout the world, and its clinical efficacy high sensitivity and specificity has been repeatedly proven. At the same time, the decision to include NIPT in the algorithm of prenatal diagnostics carried out with public funds depends on its cost-effectiveness, which should be assessed separately for each country or territory due to different costs and different models of inclusion. This article presents the different countries approaches to the assessment of the medical and economic efficiency of NIPT.

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Noninvasive Prenatal Testing for Trisomies 21, 18, and 13, Sex Chromosome Aneuploidies, and Microdeletions in Average-Risk Pregnancies: A Cost-Effectiveness Analysis

Cited by 15 publications

References 12 publications

A Cost-Effectiveness Analysis of Screening Strategies Involving Non-Invasive Prenatal Testing for Trisomy 21

A Cost-Effectiveness Analysis of Screening Strategies Involving Non-Invasive Prenatal Testing for Trisomy 21

Non‐invasive prenatal testing for the prenatal screening of sex chromosome aneuploidies: A systematic review and meta‐analysis of diagnostic test accuracy studies

Non-Invasive Prenatal Testing: the International Experience of Medical and Economic NIPT Efficiency Evaluation

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