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Table 4 Univariate sensitivity analysis: when the cost per NIPT is €150 or €76

From: 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

Screening strategy 1st and 2nd trimester screening (current screening) NIPT as contingent testing NIPT as first-line testing
Effectiveness
No of women undergoing 1st and 2nd trimester screening tests 66,799 66,799 1336
No of women undergoing NIPT 0 3152 66,799
No of NIPT with a positive result 0 251 280
No of ITa 3275 579 700
No of procedure-related miscarriages 23 4 5
No of T21 cases detected 271 269 296
Costs
1st and 2nd trimester screening tests €5,292,716 €5,292,716 €101,536
NIPT = €150 €0 €491,550 €10,940,400
NIPT = €76 €0 €249,052 €5,543,136
IT €3,093,565 €546,923 €661,220
Hospitalisation due to amniotic fluid leakage and pregnancy termination owing to T21 €515,591 €469,362 €518,389
Total costs when NIPT = €150 €8,901,872 €6,800,551 €12,221,545
Total costs when NIPT = €76 €8,901,872 €6,558,053 €6,824,281
Economic analysis NIPT as first-line testing vs 1st and 2nd trimester screening NIPT as contingent testing vs 1st and 2nd trimester screening NIPT as first-line testing vs NIPT as contingent testing
Incremental cost when TPNI = €150 €3,319,673 €− 2,101,321 €5,420,994
Incremental cost when TPNI = €76 €− 2,077,591 €− 2,343,819 €266,228
Incremental effectiveness (T21 extra cases detected) 25 − 2 27
ICER (€/case T21 extra detected) when NIPT = €150 132,787 200,777
ICER (€/case T21 extra detected) when NIPT = €76 Dominant 9860
  1. ICER, incremental cost-effectiveness ratio; IT, invasive tests, NIPT: non-invasive prenatal testing; T21, trisomy 21
  2. aOut of the total of the total number of invasive diagnostic tests performed, 271 correspond to pregnant women with a NT ≥ 3.5 mm (considered high-risk)