() >4m Aim: To analyze the economic value of Replacing conventional screening with — replacing conventional fetal aneuploidy would reduce healthcare costs if it can be analysis screening approaches with cfDNA testing in provided for $744 or less in the general the general pregnancy population. pregnancy population. The most influential variables were timing of screening entry, Setting: United States screening costs, and pregnancy termination Population: annual US pregnancy rates. population Of the 13,176 affected pregnancies Methods: Sensitivity and specificity for fetal undergoing screening, cfDNA detected aneuploidies, trisomy 21, trisomy 18, trisomy 96.5% (12,717/13,176) of cases, compared 13, and monosomy X, were estimated using with 85.9% (11,314/13,176) by conventional published data and modeling of both first- approaches. cfDNA reduced invasive and second trimester screening. Costs were procedures by 60.0%, with cfDNA and assigned for each prenatal test component conventional methods resulting in 24,596 and for an affected birth. The overall cost to and 61,430 invasive procedures, the healthcare system considered screening respectively. The number of costs, the number of aneuploid cases euploid fetal losses was reduced by detected, invasive procedures performed, 73.5% (194/264) in the general screening procedure-related euploid losses, and population affected pregnancies averted. Sensitivity analyses evaluated the effect of variation in parameters. Costs were reported in 2014 US Dollars.
() analysis — >4m Aim: To analyze the economic value of replacing conventional fetal aneuploidy screening approaches with cfDNA testing in the general pregnancy population. Setting: United States Population: annual US pregnancy population Methods: Sensitivity and specificity for fetal aneuploidies, trisomy 21, trisomy 18, trisomy 13, and monosomy X, were estimated using published data and modeling of both first- and second trimester screening. Costs were assigned for each prenatal test component and for an affected birth. The overall cost to the healthcare system considered screening costs, the number of aneuploid cases detected, invasive procedures performed, procedure-related euploid losses, and affected pregnancies averted. Sensitivity analyses evaluated the effect of variation in parameters. Costs were reported in 2014 US Dollars. Replacing conventional screening with would reduce healthcare costs if it can be provided for $744 or less in the general pregnancy population. The most influential variables were timing of screening entry, screening costs, and pregnancy termination rates. Of the 13,176 affected pregnancies undergoing screening, cfDNA detected 96.5% (12,717/13,176) of cases, compared with 85.9% (11,314/13,176) by conventional approaches. cfDNA reduced invasive procedures by 60.0%, with cfDNA and conventional methods resulting in 24,596 and 61,430 invasive procedures, respectively. The number of euploid fetal losses was reduced by 73.5% (194/264) in the general screening population