Document Detail


Cost-effectiveness analysis of prenatal diagnosis intervention for Down's syndrome in China.
MedLine Citation:
PMID:  17234028     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 alpha-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.
Authors:
Yingyao Chen; Xu Qian; Jun Li; Jie Zhang; Annie Chu; Stuart O Schweitzer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of technology assessment in health care     Volume:  23     ISSN:  0266-4623     ISO Abbreviation:  Int J Technol Assess Health Care     Publication Date:  2007  
Date Detail:
Created Date:  2007-01-19     Completed Date:  2007-04-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508113     Medline TA:  Int J Technol Assess Health Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  138-45     Citation Subset:  IM    
Affiliation:
National Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, P.R. China. yychen@shmu.edu.cn
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MeSH Terms
Descriptor/Qualifier:
Adult
China
Cost-Benefit Analysis
Data Collection
Down Syndrome / diagnosis*
Female
Humans
Pregnancy
Prenatal Diagnosis / economics*

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