Abstract
COST-BENEFIT ANALYSIS OF PRENATAL DIAGNOSIS BY MOLECULAR KARYOTYPING VERSUS CONVENTIONAL KARYOTYPING FOR DETECTION OF ANEUPLOIDIES IN RAMATHIBODI HOSPITAL

Wirada D., Panyu P.*, Chayada T., Budsaba R., Takol C. and Oraluck P.

ABSTRACT

Objective: To compare the benefit to cost ratio of prenatal diagnosis (PND) for aneuploidy between KaryoLite BACs-on BeadsTM (KL-BoBsTM) and conventional karyotyping techniques in health care purchaser's perspective. Study Design: Health economicevaluation with cost-benefit analysis using decision tree model in prospective study design. Materials And Methods: A total of 160 singleton pregnancies with obstetric indications for amniocentesis were enrolled from 11th November 2016 to 11th March 2017 at 16-23 weeks’ gestation. Subjects were randomly and equally allocated into 2 groups. All participants were interviewed and completed the questionnaires. Total costs were collected. The benefit in this study was the health state change from relieving of anxiousness described in term of willingness to pay (WTP) for faster turnaround time in each laboratory method. The decision tree model was applied to estimate the ratio of incremental benefit to incremental cost. One way probabilistic sensitivity analyses was applied. Results: From the purchaser’s perspective view, the incremental benefit to incremental cost ratio when comparing KL-BoBsTM to conventional karyotyping method was 1.48. The incremental benefit was 874 Thai Baht (24.9 US$) more than the incremental cost. The WTP for faster turnaround time which would relieve the participants from anxiousness in conventional karyotyping group was the most powerful parameter using one-way sensitivity analysis. Conclusion: KL-BoBsTM technique is valuable in the perspective of pregnant women undergoing amniocentesis for high risk of aneuploidy. The incremental benefit was 1.48-folds higher than incremental cost when comparing KL-BoBsTM to conventional karyotyping method.

Keywords: Prenatal diagnosis, aneuploidies, conventional karyotyping, BACs-on BeadsTM, cost-benefit analysis.


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