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Cost-effectiveness analysis of prenatal diagnosis intervention for Down's syndrome in China

Published online by Cambridge University Press:  18 January 2007

Yingyao Chen ,
Xu Qian ,
Jun Li ,
Jie Zhang ,
Annie Chu  and
Stuart O. Schweitzer
Yingyao Chen
Affiliation:
Fudan University
Xu Qian
Affiliation:
Fudan University
Jun Li
Affiliation:
Fudan University
Jie Zhang
Affiliation:
Fudan University
Annie Chu
Affiliation:
Fudan University
Stuart O. Schweitzer
Affiliation:
UCLA School of Public Health
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Abstract

Objectives: The cost-effectiveness of prenatal diagnosis intervention for Down's syndrome (DS) in China was assessed and evidence-based information for policy makers and providers is presented.

Methods: Based on field surveys in four selected cities in China and a literature review, the economic evaluation of prenatal diagnosis for DS from a societal perspective is conducted by cost-effectiveness analysis.

Results: In current clinical practice, for a cohort of 10,000 pregnant women, the strategy that delivers karyotyping by chorionic villus sampling (CVS) or amniocentesis (AC) only to those pregnant women 35 years of age and older (maternal age screening strategy) can detect .67 DS births. The strategy that offers the diagnostic test after maternal serum screening with α-fetoprotein and human chorionic gonadotrophin (maternal serum screening strategy) can detect 1.41 DS births. The cost per prevented DS birth by the maternal age screening strategy and maternal serum screening strategy is US$13,091 and US$56,048, respectively. Sensitivity analysis shows that the maternal serum screening strategy can be cost-effective if uptake rate of CVS or AC for patients with positive serum tests increase while the cost of serum screening decreases.

Conclusions: Although, in general, serum screening has been found to be more cost-effective than maternal age screening, this appears not to be the case in China. The reasons appear to be low uptake rate of the maternal serum strategy, low uptake rate of CVS or AC, and the high price of serum screening. Our findings are that health system factors concerning technology utilization are important determinants of the technology's efficiency.

Keywords

Cost-effectiveness analysisPrenatal diagnosisDown's syndrome
Type
RESEARCH REPORTS
Information
International Journal of Technology Assessment in Health Care , Volume 23 , Issue 1 , January 2007 , pp. 138 - 145
Copyright
© 2007 Cambridge University Press

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