() 300,000 Aim: To evaluate the cost-effectiveness of Universal cfDNA costs an additional Study assumed a — different strategies of for trisomy 21 $134,636,832 compared with current sensitivity of 98% analysis screening in comparison with current practice, but detects 123 more trisomy 21 and specificity practice. cases (at an incremental cost of $1,094,608 of 97% for cfDNA per case) and avoids 90 PRL. testing. No Setting: Australia failure rate for women >40 years was the most Population: A theoretical cohort of singleton assigned. strategy, costing an incremental pregnancies $81,199 per additional trisomy 21 case Estimates based Methods: The strategies compared were the detected and avoiding 95 PRL. on costs of following: current practice, cfDNA as a $102.95 for cFTS, The cost of needs to decrease second-tier investigation, cfDNA only in $575 for cfDNA significantly if it is to replace current practice women >35 years, cfDNA only in women >40 testing and on a purely cost-effectiveness basis. years and cfDNA for all women. The direct $528.95 for However, it may be beneficial to use cfDNA costs (low and high estimates) were derived invasive testing. as first-line screening in selected high-risk using both health system costs and patient patients. Further evaluation is needed to out-of-pocket expenses. The number of consider the longer-term costs and benefits trisomy 21 cases detected and of screening. losses (PRL) were compared between strategies. The incremental cost per case detected was the primary measure of cost-effectiveness.
() analysis — 300,000 Aim: To evaluate the cost-effectiveness of different strategies of for trisomy 21 screening in comparison with current practice. Setting: Australia Population: A theoretical cohort of singleton pregnancies Methods: The strategies compared were the following: current practice, cfDNA as a second-tier investigation, cfDNA only in women >35 years, cfDNA only in women >40 years and cfDNA for all women. The direct costs (low and high estimates) were derived using both health system costs and patient out-of-pocket expenses. The number of trisomy 21 cases detected and losses (PRL) were compared between strategies. The incremental cost per case detected was the primary measure of cost-effectiveness. Universal cfDNA costs an additional $134,636,832 compared with current practice, but detects 123 more trisomy 21 cases (at an incremental cost of $1,094,608 per case) and avoids 90 PRL. for women >40 years was the most strategy, costing an incremental $81,199 per additional trisomy 21 case detected and avoiding 95 PRL. The cost of needs to decrease significantly if it is to replace current practice on a purely cost-effectiveness basis. However, it may be beneficial to use cfDNA as first-line screening in selected high-risk patients. Further evaluation is needed to consider the longer-term costs and benefits of screening. Study assumed a sensitivity of 98% and specificity of 97% for cfDNA testing. No failure rate assigned. Estimates based on costs of $102.95 for cFTS, $575 for cfDNA testing and $528.95 for invasive testing.
cfDNA%20testing%20evidence%20evaluation%2016May17.docx