Fetal Down syndrome screening models for developing countries; Part II: Cost-benefit analysis

Table 3 Costs used in the simulations (expressed in USD, adjusted value for the year 2019)

Costs	Type of distribution	Cost from government perspectives (direct medical)	Direct non-medical cost of a woman and relatives	Indirect cost	Cost from societal perspective	References
FTS (first trimester screen)	gamma	30.63	58.02		88.65	Calculated by micro-costing
STS (second trimester screen)	gamma	33.65	58.02		91.67
Amniocentesis and chromosome study & counseling	gamma	141.56	58.02		199.58
Intended termination of pregnancy	gamma	77.31	–		77.31
Vaginal delivery	gamma	66.50	–		66.50
Cesarean delivery	gamma	245.64	–		245.64
NIPS	gamma	416.86	58.02		474.88	Thai NIPS
Lifetime costs of taking care of DS	gamma	103,251.46		479,892.65	583,144	Ref [2, 9,10,11]^a
Indirect costs of normal child (in case of termination due to false positive)	gamma			44,229	44,229	Ref [3]
WTP to avert having DS child in women of all age	gamma	1945			1945	Questionnaire

^a This study transfers the lifetime costs of Down syndrome children from the previous studies to measure the medical costs (ref 11) and indirect lifetime costs. Since the information from those studies was based on samples in the United States and the studies were conducted in 2011 and 2017, the value of transferred cost applied in this study needs to be adjusted according to Thailand context and the time of valuation. The purchasing power and currency adjustment between Thai and the U.S. is adjusted by the PPP conversion factor (World bank, 2019: PPP conversion factor, private consumption (LCU per international $) Retrieved October 1, 2019, from http://data.worldbank.org/indicator/PA.NUS.PRVT.PP) and the different time period is adjusted by Consumer Price Index (CPI) (Ministry of Commerce, 2019: Consumer Price Index of THAILAND YEAR 2019 BASE YEAR 2011 and 2017. Retrieved October 1, 2019, from http://www.indexpr.moc.go.th/price_present/TableIndexG_region.asp?table_name=cpig_index_country&province_code=5&type_code=g&check_f=i&year_base=2560&nyear=2562 AND Bank of Thailand (2019) Historical Foreign Exchange Rates Retrieved October 1, 2019, from https://www.bot.or.th/english/_layouts/application/exchangerate/exchangerateago.aspx)

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