ArticleBMJ open2014
Introducing the non-invasive prenatal test for trisomy 21 in Belgium: a cost-consequences analysis.
Article in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 79 citations in OpenAlex.
- Impact of Structural Differences on the Modeled Cost-Effectiveness of Noninvasive Prenatal Testing.Medical decision making : an international journal of the Society for Medical Decision Making · 2024Pooled it
- Cost-effectiveness of cell-free DNA in maternal blood testing for prenatal detection of trisomy 21, 18 and 13: a systematic review.The European journal of health economics : HEPAC : health economics in prevention and care · 2018Pooled it
- Cost-effectiveness of advanced hybrid closed loop therapy compared to standard insulin therapy for type 1 diabetes in pregnancy: an economic evaluation of the CRISTAL trial.EClinicalMedicine · 2025Article
- Implementing genomic medicine in New Zealand.Journal of the Royal Society of New Zealand · 2025Article
- Cost-effectiveness of different screening strategies for Down syndrome: a real-world analysis in 140,472 women.Frontiers in public health · 2025Article
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- Whole genome non-invasive prenatal testing in prenatal screening algorithm: clinical experience from 12,700 pregnancies.BMC pregnancy and childbirth · 2022Article
- Biochemical Serum Markers Influencing Maternal Age Risk for Down's Syndrome in Quadruple Marker.Cureus · 2022Article
- Introducing cell-free DNA noninvasive testing in a Down syndrome public health screening program: a budget impact analysis.Cost effectiveness and resource allocation : C/E · 2020Article
- A Retrospective Analysis Of Different Contingent Screening Models For Fetal Down Syndrome In Southwestern China.Scientific reports · 2020Article
- Assessment of a change of protocol of prenatal screening by inclusion of non-invasive prenatal diagnosis.Advances in laboratory medicine · 2020Article
- Should pregnant women be charged for non-invasive prenatal screening? Implications for reproductive autonomy and equal access.Journal of medical ethics · 2020Article
- Fetal Down syndrome screening models for developing countries; Part II: Cost-benefit analysis.BMC health services research · 2019Article
- Clinical validation of a novel automated cell-free DNA screening assay for trisomies 21, 13, and 18 in maternal plasma.Prenatal diagnosis · 2019Article
- Targeted fetal cell-free DNA screening for aneuploidies in 4,594 pregnancies: Single center study.Molecular genetics & genomic medicine · 2019Article
- Development of a biophysical screening model for gestational hypertensive diseases.Journal of biomedical science · 2019Article
- The consequences of implementing non-invasive prenatal testing with cell-free foetal DNA for the detection of Down syndrome in the Spanish National Health Service: a cost-effectiveness analysis.Cost effectiveness and resource allocation : C/E · 2019Article
- Clinical and Economic Impact of Adopting Noninvasive Prenatal Testing as a Primary Screening Method for Fetal Aneuploidies in the General Pregnancy Population.Fetal diagnosis and therapy · 2019Article
- Sequencing of Circulating Cell-free DNA during Pregnancy.The New England journal of medicine · 2018Review
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe first- and second-trimester screening for trisomy 21 (T21) are reimbursed for all pregnant women in Belgium. Using a cut-off risk of 1:300 for T21, about 5% of all pregnant women are referred for definitive prenatal diagnosis using an invasive test, at a sensitivity of (only) 72.5%. The sensitivity and specificity of the non-invasive prenatal test (NIPT) are over 99% but come at a cost of €460 (£373) per test. The objective is to estimate the consequences of introducing NIPT for the detection of T21.
methodsA cost-consequences analysis was performed presenting the impact on benefits, harms and costs. Context-specific real-world information was available to set up a model reflecting the current screening situation in Belgium. This model was used to construct the second and first line NIPT screening scenarios applying information from the literature on NIPT's test accuracy.
resultsIntroducing NIPT in the first or second line reduces harm by decreasing the number of procedure-related miscarriages after invasive testing. In contrast with NIPT in the second line, offering NIPT in the first line additionally will miss fewer cases of T21 due to less false-negative test results. The introduction of NIPT in the second line results in cost savings, which is not true for NIPT at the current price in the first line. If NIPT is offered to all pregnant women, the price should be lowered to about €150 to keep the screening cost per T21 diagnosis constant.
conclusionsIn Belgium, the introduction and reimbursement of NIPT as a second line triage test significantly reduces procedure-related miscarriages without increasing the short-term screening costs. Offering and reimbursing NIPT in the first line to all pregnant women is preferred in the long term, as it would, in addition, miss fewer cases of T21. However, taking into account the government's limited resources for universal reimbursement, the price of NIPT should first be lowered substantially before this can be realised.
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