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

2007 ◽  
Vol 23 (1) ◽  
pp. 138-145 ◽  
Author(s):  
Yingyao Chen ◽  
Xu Qian ◽  
Jun Li ◽  
Jie Zhang ◽  
Annie Chu ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Cost Effectiveness ◽  
Uptake Rate ◽  
Maternal Age ◽  
Cost Effective ◽  
Screening Strategy ◽  
Maternal Serum ◽  
Maternal Serum Screening ◽  
Serum Screening ◽  
The Cost

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.

Prenatal diagnosis of trisomy 20 mosaicism by maternal serum screening for Down syndrome

1999 ◽  
Vol 86 (2) ◽  
pp. 175-177 ◽  
Author(s):  
Jen-Huang Chen ◽  
Te-Yao Hsu ◽  
Chia-Yu Ou ◽  
Lih-Feng Chang ◽  
Shiuh-Young Chang ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Prenatal Diagnosis ◽  
Maternal Serum ◽  
Maternal Serum Screening ◽  
Serum Screening

A cost-benefit analysis for sonographic screening for renal tumors.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 665-665
Author(s):  
Shmuel Roizman ◽  
Moshe Leshno ◽  
Miki Haifler ◽  
Yishai Hode Rappaport ◽  
Amnon Zisman
Keyword(s):  
Targeted Therapy ◽  
Cost Effectiveness ◽  
Cost Benefit ◽  
Cost Effective ◽  
Screening Strategy ◽  
Renal Tumors ◽  
Stage Migration ◽  
Mathematical Framework ◽  
Abdominal Ultrasonography ◽  
The Cost

665 Background: In the last 2 decades, the rates of metastatic Renal Cell Carcinoma (RCC) at diagnosis declined from 33% to 17%This fact is attributed to massive penetration of cross sectional imaging leading to a marked stage migration. The cost of targeted therapy for metastatic RCC patients is very high. These trends led us to hypothesize that screening for RCC with ultrasound may be cost effective. Objective: To assess the cost effectiveness of screening with ultrasound for renal tumors in the general population over 60 years of age. Methods: Using the Markov model, a mathematical framework was set up describing the course of disease with and without screening for RCC using abdominal ultrasonography. Quality Adjusted Life Year (QALY) and financial costs were the outputs of the model. Results: Average costs for the screening strategy was 137.4 U$ and for non-screening was 31.4 U$. Screening and non-screening strategy would add an average of 21.7396 and 21.7385 QALY, respectively. An increase of 0.001 QALY equates to Incremental Cost Effectiveness Ratio (ICER) of 86,4 U$ per QALY, Currently, the cost which is considered cost effective for 1 QALY point is approximately 27,548.21 U$. The two variables most influential on the model output were prevalence of RCC and US cost. Conclusions: To our knowledge, this is the sole cost benefit screening study performed for RCC in the targeted therapy era. Screening for renal tumors using abdominal ultrasonography at a cost of 35.81 U$ per exam is cost effective. Our findings are highly suggestive that early screening for RCC may be cost effective for preventing RCC metastatic disease and nevertheless will save lives.

Neural Tube Defects: Maternal Serum Screening and Prenatal Diagnosis

1978 ◽  
Vol 25 (3) ◽  
pp. 619-629 ◽  
Author(s):  
Barbara F. Crandall ◽  
Thomas B. Lebherz ◽  
Raimund Freihube
Keyword(s):  
Prenatal Diagnosis ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Maternal Serum ◽  
Maternal Serum Screening ◽  
Serum Screening

scholarly journals Repeat screening for syphilis in pregnancy as an alternative screening strategy in the UK: a cost-effectiveness analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038505
Author(s):  
Susie Huntington ◽  
Georgie Weston ◽  
Farah Seedat ◽  
John Marshall ◽  
Heather Bailey ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Pregnant Women ◽  
Neonatal Death ◽  
Cost Effective ◽  
Screening Strategy ◽  
Base Case ◽  
Scenario Analyses ◽  
The Uk ◽  
The Cost ◽  
In Pregnancy

ObjectivesTo assess the cost-effectiveness of universal repeat screening for syphilis in late pregnancy, compared with the current strategy of single screening in early pregnancy with repeat screening offered only to high-risk women.DesignA decision tree model was developed to assess the incremental costs and health benefits of the two screening strategies. The base case analysis considered short-term costs during the pregnancy and the initial weeks after delivery. Deterministic and probabilistic sensitivity analyses and scenario analyses were conducted to assess the robustness of the results.SettingUK antenatal screening programme.PopulationHypothetical cohort of pregnant women who access antenatal care and receive a syphilis screen in 1 year.Primary and secondary outcome measuresThe primary outcome was the cost to avoid one case of congenital syphilis (CS). Secondary outcomes were the cost to avoid one case of intrauterine fetal demise (IUFD) or neonatal death and the number of women needing to be screened/treated to avoid one case of CS, IUFD or neonatal death. The cost per quality-adjusted life year gained was assessed in scenario analyses.ResultsBase case results indicated that for pregnant women in the UK (n=725 891), the repeat screening strategy would result in 5.5 fewer cases of CS (from 8.8 to 3.3), 0.1 fewer cases of neonatal death and 0.3 fewer cases of IUFD annually compared with the single screening strategy. This equates to an additional £1.8 million per case of CS prevented. When lifetime horizon was considered, the incremental cost-effectiveness ratio for the repeat screening strategy was £120 494.ConclusionsUniversal repeat screening for syphilis in pregnancy is unlikely to be cost-effective in the current UK setting where syphilis prevalence is low. Repeat screening may be cost-effective in countries with a higher syphilis incidence in pregnancy, particularly if the cost per screen is low.

PREVENTION COULD BE LESS COST-EFFECTIVE THAN CURE: THE CASE OF HEPATITIS C SCREENING POLICIES IN FRANCE

2003 ◽  
Vol 19 (4) ◽  
pp. 632-645 ◽  
Author(s):  
Sandrine Loubière ◽  
Michel Rotily ◽  
Jean-Paul Moatti
Keyword(s):  
Cost Effectiveness ◽  
Hepatitis C ◽  
General Population ◽  
Intravenous Drug User ◽  
Cost Effective ◽  
Screening Strategy ◽  
Additional Cost ◽  
Alternative Strategies ◽  
Hcv Screening ◽  
The Cost

Objectives: To access the cost-effectiveness of French recommendations for hepatitis C virus (HCV) screening and the extent to which earlier identification of carriers may or not improve the cost-effectiveness of therapeutic strategies.Methods: Cost-effectiveness analysis were performed using decision-tree analysis and a Markov model. Four alternative strategies were compared: no screening and no treatment; initiation of HCV treatment after the diagnosis of cirrhosis; and two alternative strategies refer to the current French policies of HCV testing, i.e., two enzyme immunoblot assay (EIA) tests in series, or a polymerase chain reaction (PCR) analysis after the first positive EIA test. Costs were computed from the viewpoint of the health care system. The analysis has been applied to populations particularly at risk of infection, as well as the general population.Results: The “wait and treat cirrhosis” strategy was more cost-effective in the general population and in transfusion recipients. The incremental cost-effectiveness ratio of this strategy compared with baseline strategy was 3,476 of euros and €15,300 in respective cohorts. Considering the HCV screening strategy, the additional cost would be of €4,933 and €240,250 per additional year of life saved, respectively. In the intravenous drug user (IDU) population, the “two EIA” screening strategy was the more cost-effective alternative, with an additional cost of €3,825 per additional year of life saved.Conclusions: HCV screening would be discarded for transfusion recipients but should be encouraged for IDUs and also for the general population, in which the additional cost of screening is an order of magnitude more acceptable.

Sign in / Sign up

Export Citation Format

Share Document