Prenatal screening for Down Syndrome in Australia: costs and benefits of current and novel screening strategies
OBJECTIVE: To analyse the cost-effectiveness and performance of noninvasive prenatal testing (NIPT) for high-risk pregnancies following first-trimester screening compared with current practice.METHODS: A decision tree analysis was used to compare the costs and benefits of current practice of first-t...
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| Format: | Journal Article |
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Wiley-Blackwell Publishing Asia
2013
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| Online Access: | http://hdl.handle.net/20.500.11937/24528 |
| _version_ | 1848751455884804096 |
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| author | O'Leary, Peter Maxwell, S. Murch, A. Hendrie, Delia |
| author_facet | O'Leary, Peter Maxwell, S. Murch, A. Hendrie, Delia |
| author_sort | O'Leary, Peter |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | OBJECTIVE: To analyse the cost-effectiveness and performance of noninvasive prenatal testing (NIPT) for high-risk pregnancies following first-trimester screening compared with current practice.METHODS: A decision tree analysis was used to compare the costs and benefits of current practice of first-trimester screening with a testing pathway incorporating NIPT. We applied the model to 32 478 singleton pregnancies screened between January 2005 and December 2006, adding Medicare rebate data as a measure of public health system costs. The analyses reflect the actual uptake of screening and diagnostic testing and pregnancy outcomes in this cohort.RESULTS: The introduction of NIPT would reduce the number of invasive diagnostic procedures and procedure-related fetal losses in high-risk women by 88%. If NIPT was adopted by all women identified as high risk by first-trimester combined screening, up to 7 additional Down syndrome fetuses could be confirmed. The cost per trisomy 21 case confirmed, including NIPT was 9.7% higher ($56 360) than the current prenatal testing strategy ($51 372) at a total cost of $3.91 million compared with $3.57 million over 2 years.CONCLUSION: Based on the uptake of screening and diagnostic testing in a retrospective cohort of first-trimester screening in Western Australia, the implementation of NIPT would reduce the number of invasive diagnostic tests and the number of procedure-related fetal losses and increase the cost by 9.7% over two years. Policy planning and guidelines are urgently required to manage the funding and demand for NIPT services in Australia. |
| first_indexed | 2025-11-14T07:53:00Z |
| format | Journal Article |
| id | curtin-20.500.11937-24528 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T07:53:00Z |
| publishDate | 2013 |
| publisher | Wiley-Blackwell Publishing Asia |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-245282017-09-13T15:55:20Z Prenatal screening for Down Syndrome in Australia: costs and benefits of current and novel screening strategies O'Leary, Peter Maxwell, S. Murch, A. Hendrie, Delia Down syndrome antenatal screening policy noninvasive prenatal testing economic analysis OBJECTIVE: To analyse the cost-effectiveness and performance of noninvasive prenatal testing (NIPT) for high-risk pregnancies following first-trimester screening compared with current practice.METHODS: A decision tree analysis was used to compare the costs and benefits of current practice of first-trimester screening with a testing pathway incorporating NIPT. We applied the model to 32 478 singleton pregnancies screened between January 2005 and December 2006, adding Medicare rebate data as a measure of public health system costs. The analyses reflect the actual uptake of screening and diagnostic testing and pregnancy outcomes in this cohort.RESULTS: The introduction of NIPT would reduce the number of invasive diagnostic procedures and procedure-related fetal losses in high-risk women by 88%. If NIPT was adopted by all women identified as high risk by first-trimester combined screening, up to 7 additional Down syndrome fetuses could be confirmed. The cost per trisomy 21 case confirmed, including NIPT was 9.7% higher ($56 360) than the current prenatal testing strategy ($51 372) at a total cost of $3.91 million compared with $3.57 million over 2 years.CONCLUSION: Based on the uptake of screening and diagnostic testing in a retrospective cohort of first-trimester screening in Western Australia, the implementation of NIPT would reduce the number of invasive diagnostic tests and the number of procedure-related fetal losses and increase the cost by 9.7% over two years. Policy planning and guidelines are urgently required to manage the funding and demand for NIPT services in Australia. 2013 Journal Article http://hdl.handle.net/20.500.11937/24528 10.1111/ajo.12136 Wiley-Blackwell Publishing Asia restricted |
| spellingShingle | Down syndrome antenatal screening policy noninvasive prenatal testing economic analysis O'Leary, Peter Maxwell, S. Murch, A. Hendrie, Delia Prenatal screening for Down Syndrome in Australia: costs and benefits of current and novel screening strategies |
| title | Prenatal screening for Down Syndrome in Australia: costs and benefits of current and novel screening strategies |
| title_full | Prenatal screening for Down Syndrome in Australia: costs and benefits of current and novel screening strategies |
| title_fullStr | Prenatal screening for Down Syndrome in Australia: costs and benefits of current and novel screening strategies |
| title_full_unstemmed | Prenatal screening for Down Syndrome in Australia: costs and benefits of current and novel screening strategies |
| title_short | Prenatal screening for Down Syndrome in Australia: costs and benefits of current and novel screening strategies |
| title_sort | prenatal screening for down syndrome in australia: costs and benefits of current and novel screening strategies |
| topic | Down syndrome antenatal screening policy noninvasive prenatal testing economic analysis |
| url | http://hdl.handle.net/20.500.11937/24528 |