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dc.contributor.authorO'Leary, Peter
dc.contributor.authorMaxwell, S.
dc.contributor.authorMurch, A.
dc.contributor.authorHendrie, Delia
dc.date.accessioned2017-01-30T12:43:31Z
dc.date.available2017-01-30T12:43:31Z
dc.date.created2013-10-07T20:00:29Z
dc.date.issued2013
dc.identifier.citationO'Leary, Peter and Maxwell, Susannah and Murch, Ashleigh and Hendrie, Delia. 2013. Prenatal screening for Down Syndrome in Australia: costs and benefits of current and novel screening strategies. Australian and New Zealand Journal of Obstetrics and Gynaecology. 53 (5): pp. 425-433.
dc.identifier.urihttp://hdl.handle.net/20.500.11937/24528
dc.identifier.doi10.1111/ajo.12136
dc.description.abstract

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.

dc.publisherWiley-Blackwell Publishing Asia
dc.subjectDown syndrome
dc.subjectantenatal screening
dc.subjectpolicy
dc.subjectnoninvasive prenatal testing
dc.subjecteconomic analysis
dc.titlePrenatal screening for Down Syndrome in Australia: costs and benefits of current and novel screening strategies
dc.typeJournal Article
dcterms.source.volume53
dcterms.source.startPage425
dcterms.source.endPage433
dcterms.source.issn0004-8666
dcterms.source.titleAustralian and New Zealand Journal of Obstetrics and Gynaecology
curtin.department
curtin.accessStatusFulltext not available


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