A cost-effectiveness analysis of cell free DNA as a replacement for serum screening for Down syndrome

Prenat Diagn. 2015 May;35(5):440-6. doi: 10.1002/pd.4511.


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.

Method: 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).

Conclusion: 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.

MeSH terms

  • Abortion, Induced / economics*
  • Cost-Benefit Analysis
  • DNA / blood*
  • Down Syndrome / blood
  • Down Syndrome / diagnosis
  • Down Syndrome / economics*
  • Female
  • Humans
  • Monte Carlo Method
  • Pregnancy
  • Prenatal Diagnosis / economics*


  • DNA