Investigators at St. Paul’s Hospital and at the University of British Columbia, both located in Vancouver, developed a microsimulation decision-analytic model that they used to perform a probabilistic cost-effective analysis (CEA) of prenatal screening and diagnostic strategies for Down syndrome — the most common fetal chromosomal abnormality. For the analysis, they assumed a price of $490 for NIPT and they considered a wide range of factors, including testing accuracy, the cost of consultations, and the need for follow-up tests.
Compared with contingent NIPT (NIPT as a second-tier screening test to follow up on a questionable finding with a traditional test), universal NIPT as a first-tier screening test is not cost-effective at its current price, senior author and health economist Aslam Anis, PhD, director of the Centre for Health Evaluation & Outcome Sciences (CHÉOS) at the University of British Columbia, and colleagues wrote. This conclusion is based on an incremental cost-effectiveness ratio of more than $100,000 per quality-adjusted life year (QALY). Moreover, contingent NIPT also had the lowest cost per case of Down syndrome.
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