OBJECTIVES: Non-invasive prenatal testing (NIPT) is increasingly offered to pregnant women either independently or as an accompaniment, or alternative, to invasive diagnostic procedures. The introduction of NIPT requires consumers to be sufficiently informed in order to make a choice and provide their consent. There is evidence to suggest that poor information before screening can lead to heightened anxiety on receipt of positive or equivocal results. Therefore, providing information to those considering NIPT may have implications in terms of direct healthcare resource use or dis-benefits to the individual. However, it is currently unknown if published economic evaluations of NIPT have included resource and outcome-related implications of information provision in their analyses. The aim of this study was to systematically identify if, and how, information provision has been incorporated into economic evaluations of NIPT.
METHODS: A systematic review of model-based economic evaluations of NIPT was conducted. Medline, Embase, CINAHL and PsychINFO databases were searched using a published filter to identify economic evaluations (from NHS Economic Evaluations Database) with terms related to screening technologies. Data were extracted in line with the CHEERS statement. The results were tabulated and summarised as part of a narrative synthesis.
RESULTS: A total of 12 economic evaluations met the inclusion criteria. Two thirds of the economic evaluations did not quantify the impact of information provision in terms of healthcare costs or outcomes, although two studies (17%) recognised this as a limitation. Three studies (25%) did consider the health impact of NIPT results on the pregnant women.
CONCLUSIONS: Introducing NIPT into antenatal screening is likely to have implications in terms of health and non-health outcomes as well as healthcare resource use. Future economic evaluations of NIPT should consider taking account of information provision when estimating healthcare costs and outcomes.
