A cost-benefit analysis of prenatal diagnosis by amniocentesis in Denmark

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Abstract
A cost-benefit analysis of amniocentesis has been performed using both the excess-cost- and the replacement methods and several replacement and discount rates. In Denmark, amniocentesis is offered free of charge to various groups of pregnant women at risk for genetic disorders of the foetus. Most important is age greater than or equal to 35 years. The analysis is based on incidence and survival rates for Down syndrome (trisomy 21), Patau's syndrome (trisomy 13) and Edward's syndrome (trisomy 18), and on incidence and survival rates of children with neural tube defects. If amniocentesis were offered to all pregnant women independent of age, with a supposed participation rate of 75% and if only tangible costs and benefits were included, the analysis shows a benefit:cost ratio greater than 1.0 using discount rates of 4% and 7% (both for the excess-cost- and replacement method); a benefit:cost ratio less than 1.0 is found using 10%. The ratio is approximately 1.0, if pregnant women aged 15-19 and 20-24 years are excluded, using the discount rate 10%. Calculations for other participation rates have also been performed. If intangible costs and benefit are included, the results are uncertain.