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Updated: Apr 24, 2026

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A cost-effectiveness analysis comparing different strategies to implement noninvasive prenatal testing into a Down

Alice C Ayres1, Jennifer A Whitty, David A Ellwood

  • 1School of Medicine, Gold Coast Campus, Griffith University, Gold Coast, Queensland, Australia.

The Australian & New Zealand Journal of Obstetrics & Gynaecology
|September 9, 2014
PubMed
Summary

Noninvasive prenatal testing (NIPT) for Down syndrome (DS) is more effective when used for women over 40. Universal NIPT is costly, but NIPT for high-risk pregnancies may be beneficial.

Keywords:
benefitsconsequencescostimplementationnoninvasive prenatal testing

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Area of Science:

  • Reproductive Health
  • Genetics
  • Health Economics

Background:

  • Noninvasive prenatal testing (NIPT) is currently recommended only for high-risk pregnancies in Australia.
  • It is not yet integrated into the national Down syndrome (DS) screening program.

Purpose of the Study:

  • To compare the cost-effectiveness of various NIPT screening strategies against current practices for Down syndrome (DS).

Main Methods:

  • A decision-analytic model simulated 300,000 singleton pregnancies.
  • Strategies included current practice, NIPT as a second-tier test, and NIPT for women over 35, over 40, or universally.
  • Cost-effectiveness was measured by the incremental cost per additional DS case detected and procedure-related losses (PRL).

Main Results:

  • Universal NIPT incurred significant additional costs but detected more DS cases and avoided PRL.
  • NIPT for women over 40 years emerged as the most cost-effective strategy, with the lowest incremental cost per case detected and substantial PRL avoidance.

Conclusions:

  • NIPT cost reduction is necessary for widespread adoption over current methods based purely on cost-effectiveness.
  • Targeted NIPT for selected high-risk groups, particularly women over 40, shows promise.
  • Further research is required to assess long-term health economic impacts.