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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 1/2012

Open Access 01-01-2012 | Materno-Fetal Medicine

Economic evaluation of multiplex ligation-dependent probe amplification and karyotyping in prenatal diagnosis: a cost-minimization analysis

Authors: Elisabeth M. A. Boormans, Erwin Birnie, Mariëtte J. V. Hoffer, Merryn V. E. Macville, Robert-Jan Galjaard, Gijsbertha H. Schuring-Blom, Shama L. Bhola, Karin Huijsdens, Arie Smits, Jan M. M. van Lith

Published in: Archives of Gynecology and Obstetrics | Issue 1/2012

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Abstract

Purpose

To assess the cost-effectiveness of Multiplex Ligation-dependent Probe Amplification (MLPA, P095 kit) compared to karyotyping.

Methods

A cost-minimization analysis alongside a nationwide prospective clinical study of 4,585 women undergoing amniocentesis on behalf of their age (≥36 years), an increased risk following first trimester prenatal screening or parental anxiety.

Results

Diagnostic accuracy of MLPA (P095 kit) was comparable to karyotyping (1.0 95% CI 0.999–1.0). Health-related quality of life did not differ between the strategies (summary physical health: mean difference 0.31, p = 0.82; summary mental health: mean difference 1.91, p = 0.22). Short-term costs were lower for MLPA: mean difference €315.68 (bootstrap 95% CI €315.63–315.74; −44.4%). The long-term costs were slightly higher for MLPA: mean difference €76.42 (bootstrap 95% CI €71.32–81.52; +8.6%). Total costs were on average €240.13 (bootstrap 95% CI €235.02–245.23; −14.9%) lower in favor of MLPA. Cost differences were sensitive to proportion of terminated pregnancies, sample throughput, individual choice and performance of tests in one laboratory, but not to failure rate or the exclusion of polluted samples.

Conclusion

From an economic perspective, MLPA is the preferred prenatal diagnostic strategy in women who undergo amniocentesis on behalf of their age, following prenatal screening or parental anxiety.
Appendix
Available only for authorised users
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Metadata
Title
Economic evaluation of multiplex ligation-dependent probe amplification and karyotyping in prenatal diagnosis: a cost-minimization analysis
Authors
Elisabeth M. A. Boormans
Erwin Birnie
Mariëtte J. V. Hoffer
Merryn V. E. Macville
Robert-Jan Galjaard
Gijsbertha H. Schuring-Blom
Shama L. Bhola
Karin Huijsdens
Arie Smits
Jan M. M. van Lith
Publication date
01-01-2012
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 1/2012
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-011-1921-y

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