Original Title: Análisis coste-efectividad de los microarrays para el diagnóstico prenatal de aberraciones genéticas en Espańa

Authors' objectives: To evaluate the cost-effectiveness of the prenatal diagnosis of genetic anomalies by means of aCGH in comparison with other used diagnosis strategies, from the National Health System (NHS) perspective in Spain.

Authors' results and conclusions: RESULTS: According to the results of this study, QF-PCR, karyotype & aCGH is the most effective and the most costly strategy. The combination of karyotype & QF-PCR is the less costly and the less effective strategy. aCGH is nearly as effective as QF-PCR+karyotype+aCGH and more costly than QF-PCR+karyotype. The incremental cost-effectiveness ratio for aCGH against QF-PCR+karyotype could be acceptable (4,285 € per additional diagnosis), hence aCGH could be considered a cost-effective strategy. aCGH would be a dominant strategy if its probability of uncertain results and costs were decreased.

Authors' recommendations: The strategy based in only aCGH for the prenatal diagnosis could be recommended as an alternative to the usual diagnosis strategy (QF-PCR & karyotype), although having in mind the limitations of aCGH.

Authors' methods: We developed a cost-effectiveness model (decision tree) that compared three strategies: 1) karyotype & QF-PCR; 2) karyotype, QF-PCR & aCGH; 3) aCGH. The outcome measure was the number of additional pathogenic diagnosis with a time horizon of 6 weeks and where the probabilities of occurrence were obtained from an observational study made in Spain with 906 subjects. The perspective of the analysis was that of the NHS. Direct health care costs were included such as equipment, reagents and time of professionals. The resource use was obtained from experts’ opinions about usual clinical practice in Spain. The unit costs were obtained from market prices, laboratories and hospitals accounts, and national surveys for salaries. The costs are expressed in Euros in 2012 prices. We undertook deterministic analyses and a probabilistic sensitivity analysis using Monte Carlo simulation.

Project Status: Completed

Year Published: 2013

URL for published report: https://sescs.es/analisis-coste-efectividad-microarrays-para-diagnostico-prenatal-de-aberraciones-geneticas-en-espana/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Canary Health Service

Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife

Contact Name: sescs@sescs.es

Contact Email: sescs@sescs.es