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Titre : | Cost-effectiveness threshold of first-trimester Down syndrome maternal serum screening for the use of cell-free DNA as a second-tier screening test (2021) |
Titre original: | Évaluation de la valeur seuil la plus coût-efficace des marqueurs sériques du 1er trimestre pour lemploi du test dADN circulant dans le dépistage de la trisomie 21 : une analyse médico-économique |
Auteurs : | Marie Blanquet ; Sophie Dreux ; Stéphanie Léger ; Corinne Sault ; Charline Mourgues ; Hélène Laurichesse |
Type de document : | Article |
Dans : | Annales de Biologie Clinique (Vol. 79, n°4, Juillet-août 2021) |
Article en page(s) : | p. 331-338 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Analyse coût-bénéfice ; Diagnostic prénatal ; Grossesse ; Premier trimestre de grossesse ; Syndrome de Down |
Mots-clés: | Acides nucléiques acellulaires |
Résumé : |
Introduction: We aimed to identify the most relevant cost-effectiveness threshold of first-trimester Down syndrome (DS) maternal serum screening (T21T1) for the use of cell-free DNA (cfDNA) as a second-tier test in the French context.
Method: A cost-effectiveness analysis was performed on 108,121 singleton pregnancies using a simulation model. The threshold of T21T1 screening was ranged from 1/51 to 1/1,000 in steps of 1/50. The most relevant threshold was based on cost-effectiveness ratio (CER; costs = direct medical costs after T21T1 screening/ effectiveness = number of DS cases identified). Results: In the sample, 161 cases of DS were identified. At the threshold of ≥ 1/50, 47.2% of total DS cases were diagnosed. In the simulation model, for a threshold ≥ 1/250, 73.9% of total DS cases were diagnosed, for ≥ 1/500, 78.8% and for ≥ 1/1,000, only two additional cases were diagnosed. The slope of the cost increase was slight from threshold ≥ 1/250 (978,634 ), then steep up to 1/500 (1,966,576 ) and increased exponentially to 1/1,000 (3,980,216 ). The CER was 38,560 for a threshold ≥ 1/500. Conclusion: The most cost-effective threshold for cfDNA as a second-tier test seems to be ≥ 1/500. For higher thresholds, costs increase dramatically for only a few additional cases of DS identified. |
Disponible en ligne : | Oui |
En ligne : | https://search-ebscohost-com.ezproxy.vinci.be/login.aspx?direct=true&db=mdc&AN=34259156&site=ehost-live |