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Table 7 Univariate sensitivity analysis: when the rate of analytic failure of NIPT varies from 0 to 12%

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

Testing strategy 1st and 2nd trimester screening (current screening) NIPT as contingent testing NIPT as first-line testing
Failure rate of 0% Failure rate of 12% Failure rate of 0% Failure rate of 12%
Effectiveness
No of women undergoing 1st and 2nd trimester screening tests 66,799 66,799 66,799 0 8016
No of women undergoing NIPT 0 3152 3152 66,799 66,799
No of NIPT with a positive result 0 256 225 286 252
No of ITa 3275 523 853 648 964
No of procedure-related miscarriages 23 4 6 5 7
No of T21 cases detected 271 269 269 297 294
Costs
1st and 2nd trimester screening tests €5,292,716 €5,292,716 €5,292,716 0€ €609,216
NIPT €0 €1,733,600 €1,940,400 38,608,900€ €43,126,050
IT €3,093,565 €494,026 €805,744 612,101€ €910,594
Hospitalisation due to amniotic fluid leakage and pregnancy termination owing to T21 €515,591 €467,785 €474,093 520,214€ €519,470
Total costs €8,901,872 €7,988,127 €8,512,953 39,741,215€ €45,165,330
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
Failure rate of 0% Failure rate of 12% Failure rate of 0% Failure rate of 12% Failure rate of 0% Failure rate of 12%
Incremental cost €30,839,343 36,263,458 €-913,745 €-388,919 €31,753,688 €36,652,378
Incremental effectiveness (T21 extra cases detected) 26 23 − 2 − 2 28 25
ICER (€/T21 extra case detected) 1,186,129 1,576,672 1,134,039 1,466,095
  1. ICER, incremental cost-effectiveness ratio; IT, invasive tests; NIPT, non-invasive prenatal testing; T21, trisomy 21
  2. aOut of the total number of invasive diagnostic test performed, 271 correspond to pregnant women with a NT ≥ 3.5 mm (considered high-risk)