Cost-effectiveness analysis of prenatal population-based fragile X carrier screening

Thomas J. Musci, Aaron Caughey, Wendy Smith, Martin Schwartz, Jone Sampson

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Objective: To investigate the cost-effectiveness of a widespread prenatal population-based fragile X carrier screening program. Study design: A decision tree was designed comparing screening versus not screening for the fragile X mental retardation protein 1 premutation in all pregnant women. Baseline values included a prevalence of fragile X mental retardation protein 1 premutations of 3.3 per 1000, a premutation expansion rate of 11.3%, and a 99% sensitivity of the screening test. The cost of the screening test was varied from $75 to $300. A sensitivity analysis of the probabilities, utilities, and costs was performed. Results: The screening strategy would lead to the identification of 80% of the fetuses affected by fragile X annually. Assuming the cost of $95 per test and only one child, the program would be cost effective at $14,858 per quality-adjusted life-year. The screening strategy remained cost effective up to $140 per test and 1 child per woman or for 2 children per woman up to a cost of $281 per test. Conclusion: Population-based screening for the fragile X premutation may be both clinically desirable and cost effective. Prospective pilot studies of this screening modality are needed in the prenatal setting.

Original languageEnglish (US)
Pages (from-to)1905-1915
Number of pages11
JournalAmerican Journal of Obstetrics and Gynecology
Volume192
Issue number6
DOIs
StatePublished - Jun 2005
Externally publishedYes

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Cost-Benefit Analysis
Costs and Cost Analysis
Fragile X Mental Retardation Protein
Population
Decision Trees
Quality-Adjusted Life Years
Pregnant Women
Fetus
Prospective Studies

Keywords

  • Cost-effectiveness analysis
  • Fragile X screening
  • Prenatal genetic screening

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Cost-effectiveness analysis of prenatal population-based fragile X carrier screening. / Musci, Thomas J.; Caughey, Aaron; Smith, Wendy; Schwartz, Martin; Sampson, Jone.

In: American Journal of Obstetrics and Gynecology, Vol. 192, No. 6, 06.2005, p. 1905-1915.

Research output: Contribution to journalArticle

Musci, Thomas J. ; Caughey, Aaron ; Smith, Wendy ; Schwartz, Martin ; Sampson, Jone. / Cost-effectiveness analysis of prenatal population-based fragile X carrier screening. In: American Journal of Obstetrics and Gynecology. 2005 ; Vol. 192, No. 6. pp. 1905-1915.
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