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. 2012 Jan;285(1):67-75.
doi: 10.1007/s00404-011-1921-y. Epub 2011 May 19.

Economic evaluation of multiplex ligation-dependent probe amplification and karyotyping in prenatal diagnosis: a cost-minimization analysis

Elisabeth M A Boormans  1 , Erwin Birnie, Mariëtte J V Hoffer, Merryn V E Macville, Robert-Jan Galjaard, Gijsbertha H Schuring-Blom, Shama L Bhola, Karin Huijsdens, Arie Smits, Jan M M van Lith
Affiliations

Economic evaluation of multiplex ligation-dependent probe amplification and karyotyping in prenatal diagnosis: a cost-minimization analysis

Elisabeth M A Boormans et al. Arch Gynecol Obstet. 2012 Jan.

Abstract

Purpose: To assess the cost-effectiveness of Multiplex Ligation-dependent Probe Amplification (MLPA, P095 kit) compared to karyotyping.

Methods: A cost-minimization analysis alongside a nationwide prospective clinical study of 4,585 women undergoing amniocentesis on behalf of their age (≥36 years), an increased risk following first trimester prenatal screening or parental anxiety.

Results: Diagnostic accuracy of MLPA (P095 kit) was comparable to karyotyping (1.0 95% CI 0.999-1.0). Health-related quality of life did not differ between the strategies (summary physical health: mean difference 0.31, p = 0.82; summary mental health: mean difference 1.91, p = 0.22). Short-term costs were lower for MLPA: mean difference <euro>315.68 (bootstrap 95% CI <euro>315.63-315.74; -44.4%). The long-term costs were slightly higher for MLPA: mean difference <euro>76.42 (bootstrap 95% CI <euro>71.32-81.52; +8.6%). Total costs were on average <euro>240.13 (bootstrap 95% CI <euro>235.02-245.23; -14.9%) lower in favor of MLPA. Cost differences were sensitive to proportion of terminated pregnancies, sample throughput, individual choice and performance of tests in one laboratory, but not to failure rate or the exclusion of polluted samples.

Conclusion: From an economic perspective, MLPA is the preferred prenatal diagnostic strategy in women who undergo amniocentesis on behalf of their age, following prenatal screening or parental anxiety.

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References

    1. Ogilvie CM, Lashwood A, Chitty L, et al. The future of prenatal diagnosis: rapid testing or full karyotype? An audit of chromosome abnormalities and pregnancy outcomes for women referred for Down’s syndrome testing. BJOG. 2005;112:1369–1375. doi: 10.1111/j.1471-0528.2005.00695.x. - DOI - PubMed
    1. Nagel HT, Knegt AC, Kloosterman MD, et al. Prenatal diagnosis in the Netherlands, 1991–2000: number of invasive procedures, indications, abnormal results and terminations of pregnancy. Prenat Diagn. 2007;27:251–257. doi: 10.1002/pd.1659. - DOI
    1. Tabor A, Madsen M, Obel EB, et al. Randomised controlled trial of genetic amniocentesis in 4606 low-risk women. Lancet. 1986;1:1287–1293. doi: 10.1016/S0140-6736(86)91218-3. - DOI - PubMed
    1. Los FJ, van Den Berg C, Wildschut HI, et al. The diagnostic performance of cytogenetic investigation in amniotic fluid cells and chorionic villi. Prenat Diagn. 2001;21:150–158. doi: 10.1002/pd.194. - DOI - PubMed
    1. van Zwieten MCB, Willems DL, Litjens LL, et al. How unexpected are unexpected findings in prenatal cytogenetic diagnosis? A literature review. Eur J Obstet Gynecol Reprod Biol. 2005;120:15–20. doi: 10.1016/j.ejogrb.2004.10.005. - DOI - PubMed

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