title: A cost-effectiveness analysis of cell free DNA as a replacement for serum screening for Down syndrome.
abstract: OBJECTIVE
  The aim of this article is to determine the cost effectiveness of cell free DNA (cfDNA) as a replacement for integrated screening using a societal cost perspective.
  
  
  METHODS
  This study used Monte-Carlo simulation with one-way and probabilistic sensitivity analysis.
  
  
  RESULTS
  Cell free DNA is more effective and less costly than integrated screening. The incremental cost-effectiveness ratio for cfDNA relative to the integrated test was -$277 955 per case detected (95th percent confidence interval -$881 882 to $532 785).
  
  
  CONCLUSIONS
  Cell free DNA screening is a cost-effective replacement for maternal serum screening when the lifetime costs of Down syndrome live births are considered. The adoption of cfDNA screening would save approximately $277 955 for each additional case detected over integrated screening.
authors.affiliation: Department of Pathology and ARUP Laboratories, School of Medicine, University of Utah, Salt Lake City, UT, USA.
authors.forename: Brandon S
authors.initials: BS
authors.lastname: Walker
authors.forename: Brian R
authors.initials: BR
authors.lastname: Jackson
authors.forename: Danielle
authors.initials: D
authors.lastname: LaGrave
authors.forename: Edward R
authors.initials: ER
authors.lastname: Ashwood
authors.forename: Robert L
authors.initials: RL
authors.lastname: Schmidt
mesh_terms: D000028:Abortion, Induced / Q000191:economics*; D003362:Cost-Benefit Analysis; D004247:DNA / Q000097:blood*; D004314:Down Syndrome / Q000097:blood / Q000175:diagnosis / Q000191:economics*; D005260:Female; D006801:Humans; D009010:Monte Carlo Method; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000191:economics*
chemical_list: D004247:DNA