Table 8 Bivariate sensitivity analysis
Testing strategy | 1st and 2nd trimester screening (current screening) | NIPT as contingent testing | NIPT as first-line testing |
|---|---|---|---|
Screening uptake of 89.97% | |||
Effectiveness | |||
No of women undergoing 1st and 2nd trimester screening tests | 66,799 | 66,799 | 1534 |
No of women undergoing NIPT | 0 | 3152 | 76,684 |
No of NIPT with a positive result | 0 | 251 | 322 |
No of ITa | 3275 | 579 | 805 |
No of procedure-related miscarriages | 23 | 4 | 5 |
No of T21 cases detected | 271 | 269 | 341 |
Costs | |||
1st and 2nd trimester screening tests | €5,292,716 | €5,292,716 | €116,584 |
NIPT = €150 | €0 | €491,550 | €12,559,350 |
NIPT = €76 | €0 | €249,052 | €6,363,404 |
IT | €3,093,565 | €546,923 | €760,403 |
Hospitalisation due to amniotic fluid leakage and pregnancy termination owing to T21 | €515,591 | €469,362 | €596,616 |
Total cost when NIPT = €150 | €8,901,872 | €6,800,551 | €14,032,953 |
Total cost when NIPT = €76 | €8,901,872 | €6,558,053 | €7,837,007 |
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 | €5,131,081 | €− 2,101,321 | €7,232,402 |
Incremental cost when TPNI = €76 | €− 1,064,865 | €− 2,343,819 | €1,278,954 |
Incremental effectiveness (T21 extra cases detected) | 70 | − 2 | 72 |
ICER (€/T21 extra case detected) when NIPT = €150 | 73,301 | – | 100,450 |
ICER (€/T21 extra case detected) when NIPT = €76 | Dominant | – | 17,763 |