Cost-Effectiveness Analysis of Prenatal Diagnostic Strategies Among Korean Pregnant Women
Author(s)
soohyun noh, Master’s Student, Doyeon Jin, Master’s Student, Hyorim Lee, Master’s Student, Jeonghoon Ahn, PhD.
Department of Health Convergence, Ewha Womans University, Seoul, Korea, Republic of.
Department of Health Convergence, Ewha Womans University, Seoul, Korea, Republic of.
OBJECTIVES: This study evaluates the cost-effectiveness of Non-Invasive Prenatal Testing (NIPT) in Korean pregnant women, focusing on clinical application. Prenatal diagnosis, a key field in obstetrics, identifies structural or functional fetal abnormalities and includes both screening and invasive tests for high-risk cases. NIPT, a newer non-invasive method analyzing fetal DNA in maternal blood, offers high diagnostic accuracy but comes with higher costs. It can reduce unnecessary invasive procedures. This study aims to assess NIPT's cost-effectiveness in Korea and provide economic evidence to support its clinical use and potential reimbursement.
METHODS: To compare prenatal screening strategies in the overall pregnant population, a decision tree model was developed to evaluate four options: No Test, Conventional Test, NIPT, and Invasive Test. The “No Test” strategy refers to cases where no prenatal diagnostic tests were performed. The “Conventional Test” involves selecting maternal serum screening as the initial test, while the “NIPT” strategy uses Non-Invasive Prenatal Testing as the first-line option. The “Invasive Test” strategy refers to choosing invasive diagnostic testing as the initial approach. The model was constructed using a Per Protocol approach, excluding pregnant women who were lost to follow-up or lacked birth outcome data.
RESULTS: A cost-utility analysis comparing four prenatal testing strategies showed that the Conventional Test was the most cost-effective, followed by NIPT, Invasive Test, and No Test. NIPT was superior to Invasive Test and more cost-effective than No Test (ICUR: 7,550,663 KRW), but the Conventional Test remained the dominant strategy.
CONCLUSIONS: Although NIPT was not more cost-effective than the conventional test (maternal serum screening) in the overall pregnant population, its higher accuracy particularly in sensitivity, specificity, and positive predictive value supports considering limited reimbursement, such as preliminary or selective coverage. With its diagnostic precision, NIPT can reduce unnecessary invasive procedures, potentially lowering fetal loss and associated social and economic burdens.
METHODS: To compare prenatal screening strategies in the overall pregnant population, a decision tree model was developed to evaluate four options: No Test, Conventional Test, NIPT, and Invasive Test. The “No Test” strategy refers to cases where no prenatal diagnostic tests were performed. The “Conventional Test” involves selecting maternal serum screening as the initial test, while the “NIPT” strategy uses Non-Invasive Prenatal Testing as the first-line option. The “Invasive Test” strategy refers to choosing invasive diagnostic testing as the initial approach. The model was constructed using a Per Protocol approach, excluding pregnant women who were lost to follow-up or lacked birth outcome data.
RESULTS: A cost-utility analysis comparing four prenatal testing strategies showed that the Conventional Test was the most cost-effective, followed by NIPT, Invasive Test, and No Test. NIPT was superior to Invasive Test and more cost-effective than No Test (ICUR: 7,550,663 KRW), but the Conventional Test remained the dominant strategy.
CONCLUSIONS: Although NIPT was not more cost-effective than the conventional test (maternal serum screening) in the overall pregnant population, its higher accuracy particularly in sensitivity, specificity, and positive predictive value supports considering limited reimbursement, such as preliminary or selective coverage. With its diagnostic precision, NIPT can reduce unnecessary invasive procedures, potentially lowering fetal loss and associated social and economic burdens.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD122
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Reproductive & Sexual Health