Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul 20;10(7):e036566.
doi: 10.1136/bmjopen-2019-036566.

Cost and outcomes of the ultrasound screening program for birth defects over time: a population-based study in France

Clément Ferrier  1 , Babak Khoshnood  2 , Ferdinand Dhombres  1 , Hanitra Randrianaivo  3 , Isabelle Perthus  4 , Jean-Marie Jouannic  5 , Isabelle Durand-Zaleski  6
Affiliations

Cost and outcomes of the ultrasound screening program for birth defects over time: a population-based study in France

Clément Ferrier et al. BMJ Open. .

Abstract

Objective: To assess trends in the average costs and effectiveness of the French ultrasound screening programme for birth defects.

Design: A population-based study.

Setting: National Public Health Insurance claim database.

Participants: All pregnant women in the 'Echantillon Généraliste des Bénéficiaires', a permanent representative sample of 1/97 of the individuals covered by the French Health Insurance System.

Main outcomes measures: Trends in the costs and in the average cost-effectiveness ratio (ACER) of the screening programme (in € per case detected antenatally), per year, between 2006 and 2014. incremental cost-effectiveness ratio (ICER) from 1 year to another were also estimated. We assessed costs related to the ultrasound screening programme of birth defects excluding the specific screening of Down's syndrome. The outcome for effectiveness was the prenatal detection rate of birth defects, assessed in a previous study. Linear and logistic regressions were used to analyse time trends.

Results: During the study period, there was a slight decrease in prenatal detection rates (from 58.2% in 2006 to 55.2% in 2014; p=0.015). The cost of ultrasound screening increased from €168 in 2006 to €258 per pregnancy in 2014 (p=0.001). We found a 61% increase in the ACER for ultrasound screening during the study period. ACERs increased from €9050 per case detected in 2006 to €14 580 per case detected in 2014 (p=0.001). ICERs had an erratic pattern, with a strong tendency to show that any increment in the cost of screening was highly cost ineffective.

Conclusion: Even if the increase in costs may be partly justified, we observed a diminishing returns for costs associated with the prenatal ultrasound screening of birth defects, in France, between 2006 and 2014.

Keywords: health economics; prenatal diagnosis; ultrasound.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Chronological evolution of the cost per pregnancy (€) of the French ultrasound screening programme for birth defects.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

  • Why are Birth Defects Surveillance Programs Important?
    Melo DG, Sanseverino MTV, Schmalfuss TO, Larrandaburu M. Melo DG, et al. Front Public Health. 2021 Nov 2;9:753342. doi: 10.3389/fpubh.2021.753342. eCollection 2021. Front Public Health. 2021. PMID: 34796160 Free PMC article. No abstract available.

References

    1. Cohen JT, Neumann PJ, Weinstein MC. Does preventive care save money? health economics and the presidential candidates. N Engl J Med 2008;358:661–3. 10.1056/NEJMp0708558 - DOI - PubMed
    1. Russell LB. The role of prevention in health reform. N Engl J Med 1993;329:352–4. 10.1056/NEJM199307293290511 - DOI - PubMed
    1. EUROCAT Central Registry EUROCAT special report: prenatal screening policies in Europe 2010. University of Ulster, 2010.
    1. Lee K, Khoshnood B, Chen L, et al. . Infant mortality from congenital malformations in the United States, 1970-1997. Obstet Gynecol 2001;98:620–7. 10.1097/00006250-200110000-00017 - DOI - PubMed
    1. Hatton F, Bouvier-Colle MH, Blondel B, et al. . [Trends in infant mortality in France: frequency and causes from 1950 to 1997]. Arch Pediatr 2000;7:489–500. 10.1016/s0929-693x(00)89004-1 - DOI - PubMed