Wilfried Gyselaers1,2, Frank Hulstaert3, Mattias Neyt3. 1. Department of Obstetrics and Gynecology, Ziekenhuis Oost-Limburg, Genk, Belgium. 2. Department of Physiology, Hasselt University, Hasselt, Belgium. 3. Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium.
Abstract
BACKGROUND: Several countries today struggle with suboptimal performances in many aspects of the fetal aneuploidy screening process and consider introducing non-invasive prenatal screening (NIPT) as a solution. In this study, costs and benefits of different scenarios for contingent NIPT screening in Belgium are evaluated with respect to partial redistribution of the national screening budget into quality improving measures for those screening activities that will be maintained when full NIPT screening is implemented. METHODS: Data from the Belgian National Institute for Health and Disability Insurance and the Study Centre for Perinatal Epidemiology were used in modeled calculations of medical and economic impact of NIPT after prior conventional screening (1) at thresholds 1:300 and 1:600, and (2) at current and improved screening sensitivity. RESULTS: Contingent NIPT screening under current screening conditions would maintain today's 7.9(0)/000 live birth prevalence of Down syndrome (LBPD) at an 11% reduction of overall short-term costs. Lowering the screening threshold to 1:600 or increasing sensitivity by 10% would reduce LBPD to 7(0)/000 at a maximum 3% increase of overall short-term costs. CONCLUSION: Today, in Belgium and in many other countries, full NIPT screening is considered too expensive for immediate introduction into the national fetal aneuploidy screening program. Contingent NIPT screening is both clinically and economically beneficial. A temporary contingent NIPT protocol allows for reinvesting economic savings into optimization of those screening aspects, which are to be maintained in parallel to full NIPT screening.
BACKGROUND: Several countries today struggle with suboptimal performances in many aspects of the fetal aneuploidy screening process and consider introducing non-invasive prenatal screening (NIPT) as a solution. In this study, costs and benefits of different scenarios for contingent NIPT screening in Belgium are evaluated with respect to partial redistribution of the national screening budget into quality improving measures for those screening activities that will be maintained when full NIPT screening is implemented. METHODS: Data from the Belgian National Institute for Health and Disability Insurance and the Study Centre for Perinatal Epidemiology were used in modeled calculations of medical and economic impact of NIPT after prior conventional screening (1) at thresholds 1:300 and 1:600, and (2) at current and improved screening sensitivity. RESULTS: Contingent NIPT screening under current screening conditions would maintain today's 7.9(0)/000 live birth prevalence of Down syndrome (LBPD) at an 11% reduction of overall short-term costs. Lowering the screening threshold to 1:600 or increasing sensitivity by 10% would reduce LBPD to 7(0)/000 at a maximum 3% increase of overall short-term costs. CONCLUSION: Today, in Belgium and in many other countries, full NIPT screening is considered too expensive for immediate introduction into the national fetal aneuploidy screening program. Contingent NIPT screening is both clinically and economically beneficial. A temporary contingent NIPT protocol allows for reinvesting economic savings into optimization of those screening aspects, which are to be maintained in parallel to full NIPT screening.
Authors: Lidia García-Pérez; Renata Linertová; Margarita Álvarez-de-la-Rosa; Juan Carlos Bayón; Iñaki Imaz-Iglesia; Jorge Ferrer-Rodríguez; Pedro Serrano-Aguilar Journal: Eur J Health Econ Date: 2017-12-16
Authors: An Chen; Henni Tenhunen; Paulus Torkki; Seppo Heinonen; Paul Lillrank; Vedran Stefanovic Journal: PLoS One Date: 2017-03-29 Impact factor: 3.240
Authors: J C Harper; K Aittomäki; P Borry; M C Cornel; G de Wert; W Dondorp; J Geraedts; L Gianaroli; K Ketterson; I Liebaers; K Lundin; H Mertes; M Morris; G Pennings; K Sermon; C Spits; S Soini; A P A van Montfoort; A Veiga; J R Vermeesch; S Viville; M Macek Journal: Hum Reprod Open Date: 2017-12-04
Authors: J C Harper; K Aittomäki; P Borry; M C Cornel; G de Wert; W Dondorp; J Geraedts; L Gianaroli; K Ketterson; I Liebaers; K Lundin; H Mertes; M Morris; G Pennings; K Sermon; C Spits; S Soini; A P A van Montfoort; A Veiga; J R Vermeesch; S Viville; M Macek Journal: Eur J Hum Genet Date: 2017-12-04 Impact factor: 4.246