Table 18:
Reference Case Analysis Results, Costs and Effectiveness for Three Prenatal Screening Strategiesa
| Strategy | Total Costs (95% CrI), $ | Cases Detected (95% CrI), n | Diagnostic Tests Performed (95% CrI), n | Diagnostic-Procedure-Related Pregnancy Losses (95% CrI), n | Affected Live Births (95% CrI), n |
|---|---|---|---|---|---|
| Traditional prenatal screening | 27,487,017 (24,140,385–30,815,491) | All: 158 (123–202) Trisomy 21: 123 (92–161) Trisomy 18: 35 (19–55) Trisomy 13: 1 (0–3) |
3,110 (2,297–4,040) | 6 (1–12) | All: 189 (162–216) Trisomy 21: 142 (119–166) Trisomy 18: 26 (17–36) Trisomy 13: 21 (12–30) |
| eFTS | 21,120,295 (18,338,516–23,895,779) | 149 (116–190) | 2,893 (2,078–3,820) | 6 (1–11) | 97 (78–116) |
| MSS | 2,719,663 (2,326,295–3,111,197) | 9 (3–16) | 218 (186–250) | 0 (0–1) | 12 (6–20) |
| No screening | 3,647,059 (2,950,378–4,341,750) | 0 | 0 | 0 | 80 (63–98) |
| Second-tier NIPT | 26,656,979 (23,423,892–29,934,127) | All: 188 (148–238) Trisomy 21: 147 (112–193) Trisomy 18: 41 (23–65) Trisomy 13: 0 (0–1) |
718 (634–814) | 1 (0–3) | All: 177 (151–204) Trisomy 21: 132 (109–155) Trisomy 18: 24 (15–35) Trisomy 13: 21 (12–30) |
| eFTS + NIPT | 20,283,588 (17,612,370–22,963,994) | 178 (139–226) | 678 (596–769) | 1 (0–3) | 86 (68–105) |
| MSS + NIPT | 2,726,332 (2,330,961–3,116,509) | 11 (4–18) | 40 (28–54) | 0 (0–1) | 12 (5–19) |
| No screening | 3,647,059 (2,950,378–4,341,750) | 0 | 0 | 0 | 80 (63–98) |
| First-tier NIPT | 61,292,985 (53,532,496–69,178,382) | All: 273 (219–337) Trisomy 21: 191 (148–245) Trisomy 18: 63 (38–97) Trisomy 13: 18 (7–35) |
2,125 (1,837–2,427) | 4 (0–8) | All: 147 (123–171) Trisomy 21: 112 (91–134) Trisomy 18: 20 (11–29) Trisomy 13: 14 (7–23) |
| First trimester | 52,509,033 (45,522,346–59,513,228) | 251 (202–313) | 1,780 (1,537–2,035) | 3 (0–7) | 60 (46–77) |
| Second trimester | 5,136,893 (4,375,162–5,895,052) | 22 (12–32) | 346 (253–442) | 0 (0–2) | 7 (2–12) |
| No screening | 3,647,059 (2,950,378–4,341,750) | 0 | 0 | 0 | 80 (63–98) |
Abbreviations: CrI, credible interval; eFTS, enhanced first-trimester screening; MSS, maternal serum screening (also known as quadruple screening); NIPT, noninvasive prenatal testing.
Note: Numbers may appear inexact due to rounding. The prevalence of chromosomal anomalies in the second trimester was lower than in the first trimester because of a risk of spontaneous pregnancy loss between the first and second trimester.
a
Mean cohort size: 145,022 pregnant people.