Cost-effectiveness of universal and contingent nipt within a multi-tariff healthcare system: A full incremental decision-analytic cohort study

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dc.authorid0000-0002-5638-3675
dc.contributor.authorBülbül, Mehmet
dc.contributor.authorÇakır, Anıl Turhan
dc.contributor.authorAydın, Gerçek
dc.contributor.authorHarma, Mehmet İbrahim
dc.contributor.authorÖztürk, Azize Cemre
dc.contributor.authorBarut, Aykut
dc.contributor.authorHarma, Müge
dc.date.accessioned2026-11-13T13:04:39Z
dc.date.available2026-11-13T13:04:39Z
dc.date.issued2026
dc.departmentFakülteler, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Kadın Hastalıkları ve Doğum Ana Bilim Dalı
dc.description.abstractObjective: To compare universal and contingent non‐invasive prenatal testing (NIPT) strategies within a multi‐tariff healthcare system using a full incremental cost‐effectiveness framework and to identify price levels at which universal NIPT becomes economically competitive with the best reflex strategy. Method: A deterministic decision‐analytic cohort model representing 1,000,000 pregnancies was developed. For each strategy, trisomy detection, false‐positive and missed cases, invasive procedures, procedure‐related fetal loss, and short‐term psycho logical quality‐adjusted life year (QALY) losses were estimated. Medical costs were derived from public, university, and private‐ sector tariffs. Incremental costs, QALY losses avoided, and cost‐effectiveness ratios were calculated across all strategies; CT‐based pairwise analyses were retained as secondary analyses. Price‐threshold analyses and probabilistic sensitivity analysis generated threshold estimates and acceptability curves. Results: Contingent NIPT strategies markedly reduced false‐positive results and invasive procedures, yielding the lowest short‐ term QALY losses. In full incremental analysis, Reflex300 was the only strategy on the frontier in private‐sector scenarios, whereas CT and Reflex300 remained on the frontier in SUT and university scenarios. uNIPT was not selected on the frontier and became economically competitive only at substantially reduced unit prices. Conclusions: Reimbursement structure strongly influenced cost‐effectiveness. Contingent NIPT was robust, whereas uNIPT required substantially lower tariff‐aligned pricing to become economically competitive.
dc.identifier.citationBülbül, M., Çakır, A. T., Aydın, G., Harma, M. İ., Öztürk, A. C., Barut, A., & Harma, M. (2026). Cost-effectiveness of universal and contingent nipt within a multi-tariff healthcare system: A full incremental decision-analytic cohort study. Prenatal Diagnosis, pp. 1-13. https://doi.org/10.1002/pd.70282
dc.identifier.doi10.1002/pd.70282
dc.identifier.endpage13
dc.identifier.issn0197-3851
dc.identifier.issn1097-0223
dc.identifier.startpage1
dc.identifier.urihttps://doi.org/10.1002/pd.70282
dc.identifier.urihttps://hdl.handle.net/20.500.13055/1721
dc.identifier.wosWOS:001905660200001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynak.otherSCI-E - Science Citation Index Expanded
dc.institutionauthorAydın, Gerçek
dc.institutionauthorid0000-0002-5638-3675
dc.language.isoen
dc.publisherWiley
dc.relation.ispartofPrenatal Diagnosis
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectCost‐Effectiveness Analysis
dc.subjectNon‐Invasive Prenatal Testing
dc.subjectPrenatal Screening
dc.subjectQuality‐Adjusted Life Years
dc.subjectReimbursement Tariffs
dc.titleCost-effectiveness of universal and contingent nipt within a multi-tariff healthcare system: A full incremental decision-analytic cohort study
dc.typeArticle
dspace.entity.typePublication

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