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dc.contributor.authorOkem, Zeynep Guldem
dc.contributor.authorOrgul, Gokcen
dc.contributor.authorKasnakoglu, Berna Tari
dc.contributor.authorCakar, Mehmet
dc.contributor.authorBeksac, Mehmet Sinan
dc.date.accessioned2020-07-28T12:54:28Z
dc.date.available2020-07-28T12:54:28Z
dc.date.issued2019
dc.identifier.issn2211-8837en_US
dc.identifier.urihttp://hdl.handle.net/11727/4800
dc.description.abstractObjectives: To provide information to the government about the budget impact of implementing non-invasive prenatal testing (NIPT) into prenatal screening strategies to detect Down syndrome (DS) in singleton pregnancies in Turkey; the likely costs or savings associated with NIPT in comparison to the current practice were calculated. Methods: A decision-analytic model was developed to calculate the cost estimates for 1,309,771 women who gave birth in 2016; 84.8% of whom were <35-years-of-age. The superior combined test (CT) among current strategies is compared with contingent NIPT for women <35-years-of-age; and usual practice of amniocentesis (AC) for women >= 35 years-of-age was replaced with universal NIPT. Results: When the market price of NIPT (1,077 PPPUS$) is used, contingent NIPT offered to high-risk women <35-years-of-age adds 34,907,225 PPPUS$; and for women-35 >= years-of-age the universal NIPT leads to 142,785,818 PPPUS$ more cost to the government compared to current strategies. The additional costs with NIPT are partially compensated by the cost-savings due to reduction of the number of invasive tests and procedure related losses (17,826,476 PPPUS$ for women <35-years-of-age and 37,070 PPPUS$ for women >= 35-years-of-age). Results are sensitive to the NIPT costs; with a lower cost of NIPT, a total saving would be 33,116,046 PPPUS$ with new strategies. Conclusions: NIPT might be the choice of prenatal screening strategies if its price is lowered to economically acceptable levels. Until that time, currently accepted protocols seem to be more realistic. On the other hand, decision makers should also consider possible savings and the women's quality of life that can be improved with the new technology. (C) 2019 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved.en_US
dc.language.isoengen_US
dc.relation.isversionof10.1016/j.hlpt.2019.10.003en_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectBudget impact analysisen_US
dc.subjectPrenatal screeningen_US
dc.subjectNon-invasive prenatal testingen_US
dc.subjectCombined testen_US
dc.subjectAmniocentesisen_US
dc.titleBudget impact of incorporating non-invasive prenatal testing in prenatal screening for Down syndrome in Turkeyen_US
dc.typearticleen_US
dc.relation.journalHEALTH POLICY AND TECHNOLOGYen_US
dc.identifier.volume8en_US
dc.identifier.issue4en_US
dc.identifier.startpage402en_US
dc.identifier.endpage407en_US
dc.identifier.wos000502891500012en_US
dc.identifier.scopus2-s2.0-85075441100en_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergien_US


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