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Table 8 Bivariate sensitivity analysis

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
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
  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)