OP05.10: A global landscape analysis of reimbursement policies for prenatal cell‐free DNA testing in public healthcare systems

White, Kerr L.; Schmid, Marianne; Kostenko, E.

doi:10.1002/uog.20697

Cited by 2 publications

(5 citation statements)

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“…Primary NIPT has been launched as an optimal choice, especially when its price was close to traditional serum screening and lower than invasive prenatal testing ( 25 , 49 ). In the current model, primary NIPT becomes dominant in incremental cost, with NIPT expense decreasing.…”

Section: Discussionmentioning

confidence: 99%

“…A sensitivity analysis was performed on various assumptions in the model ( Table 1 ). The alternative assumptions took an aging society, reducing NIPT price and compliance into consideration, to figure out the most influential parameters ( 6 , 11 , 21 , 25 , 40 ). We focused on the incremental cost analysis, which reflects “effect” via comparisons among different scenarios and “benefit” if <0.215 million US$.…”

Section: Methodsmentioning

confidence: 99%

“…Meanwhile, NIPT applications have become heterogeneous among countries or regions depending on the public health policy. The most efficient and affordable way for NIPT implementation needs to be investigated ( 25 ). We adopted NIPT primary, contingent, and age-based strategies in one theoretical model for cost-effectiveness analysis.…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

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

Wang

Liu

Yang

et al. 2022

Front. Public Health

View full text Add to dashboard Cite

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“…When sequencing is affordable, primary NIPT has been launched as the optimal choice with wide application in some countries and regions 27 . In sensitive analysis of our model, the tendency of incremental cost changed the most in primary NIPT.…”

Section: Discussionmentioning

confidence: 99%

“…In the context of rapid public health coverage of NIPT, the application became heterogeneous from countries to regions. The most efficient and affordable way for NIPT implementation needs to be explored 27 . We adopted NIPT primary, contingent and age-based strategies in one theoretical model for cost effective analysis.…”

mentioning

confidence: 99%

A Cost-Effectiveness Analysis of Screening Strategies involving Noninvasive Prenatal Testing for Trisomy 21

Wang

Liu

Yang

et al. 2020

Preprint

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In the trends of increasing advanced maternal age (AMA) and decreasing cost of Noninvasive Prenatal Testing (NIPT), we investigated the benefits and cost effectiveness of NIPT as primary or contingent strategies for trisomy 21 (T21). 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 1/1000 (Strategy 2-1 or Strategy 2-2) and age-based (Strategy 3). Strategy 3 was stratified, in which 1) for advanced maternal age (AMA) of 40 and more, prenatal diagnosis was offered, 2) for AMA of 35 to 39, NIPT was introduced, 3) if younger than 35, contingent strategy with screening risk higher than 1:300 (Strategy 3-1) or 1:1000 (Strategy 3-2) will be offered NIPT. Parameters were referred to publications or on-site verification. The primary outcome was incremental cost analysis for each strategy on baseline and alterative assumptions, which take aging society, reducing cost of NIPT and compliance into consideration. The second outcomes were total cost, cost-effect and cost-benefit analysis. If the incremental cost was less than 0.215 million US$, which was cost for raising one T21 child, or the benefit-to-cost ratio over 1, then the strategy was defined as “cost-effective”. The anticipated prenatal diagnosis was significantly reduced in Strategy 1 and 2, most notably in Strategy 2-1. For the incremental costs, strategy 2-1 was set as baseline. All other strategy costed more than raising one T21 except 3-1. In sensitivity analysis, strategy 1 costed the least when NIPT was lower than 47 US$. If NIPT less than 131 US$, the incremental cost of any strategy was less than 0.215 million US$. When the proportion of AMA accounted for more than 15% and 20% of population, incremental costs of strategy 3-1 and 3-2 were cost effective. In conclusion, contingent NIPT after traditional triple serum screening (risk higher than 1/300) was optimal in total cost (130 million US$), cost-effect (33.4 thousand US$) and cost-benefit (ratio=4.90) analysis of the model. Age-based strategy was optimal as AMA proportion and NIPT acceptance increased. The primary NIPT was most effective for certain price.

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OP05.10: A global landscape analysis of reimbursement policies for prenatal cell‐free DNA testing in public healthcare systems

Cited by 2 publications

References 0 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

A Cost-Effectiveness Analysis of Screening Strategies involving Noninvasive Prenatal Testing for Trisomy 21

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