Forget about age- and risk-based thresholds when it comes to offering pregnant women prenatal diagnostic testing with amniocentesis or chorionic villus sampling (CVS). Both tests are cost-effective, regardless of maternal age or risk of carrying an affected fetus, according to the cost-effectiveness analysis of over 500 pregnant women.
Researchers calculated that in the US, compared with no prenatal diagnostic testing, amniocentesis costs less than $15,000 per quality-adjusted life-year gained for women of all ages and risk levels. They found no age threshold below which prenatal diagnosis was cost-ineffective (i.e., greater than $50,000 per quality-adjusted life-year gained).
While the results did not depend on age or risk level, they were very sensitive to the degree of reassurance a woman required from the test. In other words, the more worried a woman was about chromosomal abnormalities and to a lesser extent, about miscarriage, the more cost-effective the test became.
Harris RA, Washington E, Nease RF Jr, et al. Cost utility of prenatal diagnosis and the risk-based threshold. Lancet. 2004;363:276-282.