Volume 35, Issue 5 p. 440-446
Original Article

A cost-effectiveness analysis of cell free DNA as a replacement for serum screening for Down syndrome

Brandon S. Walker

Brandon S. Walker

Department of Pathology and ARUP Laboratories, School of Medicine, University of Utah, Salt Lake City, UT, USA

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Brian R. Jackson

Brian R. Jackson

Department of Pathology and ARUP Laboratories, School of Medicine, University of Utah, Salt Lake City, UT, USA

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Danielle LaGrave

Danielle LaGrave

Department of Pathology and ARUP Laboratories, School of Medicine, University of Utah, Salt Lake City, UT, USA

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Edward R. Ashwood

Edward R. Ashwood

Department of Pathology and ARUP Laboratories, School of Medicine, University of Utah, Salt Lake City, UT, USA

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Robert L. Schmidt

Corresponding Author

Robert L. Schmidt

Department of Pathology and ARUP Laboratories, School of Medicine, University of Utah, Salt Lake City, UT, USA

Correspondence to: Robert Schmidt. E-mail: [email protected]Search for more papers by this author
First published: 27 April 2015
Citations: 24
Funding sources: None
Conflicts of interest: All of the authors are employees of ARUP laboratories, which provide a wide range of clinical laboratory tests including prenatal screening tests (both maternal serum screening and cfDNA).

Abstract

Objective

The aim of this article is to determine the cost effectiveness of cell free DNA (cfDNA) as a replacement for integrated screening using a societal cost perspective.

Method

This study used Monte-Carlo simulation with one-way and probabilistic sensitivity analysis.

Results

Cell free DNA is more effective and less costly than integrated screening. The incremental cost-effectiveness ratio for cfDNA relative to the integrated test was −$277 955 per case detected (95th percent confidence interval −$881 882 to $532 785).

Conclusion

Cell free DNA screening is a cost-effective replacement for maternal serum screening when the lifetime costs of Down syndrome live births are considered. The adoption of cfDNA screening would save approximately $277 955 for each additional case detected over integrated screening. © 2014 John Wiley & Sons, Ltd.