Preferences for a non‐invasive prenatal test as first‐line screening for Down Syndrome: A discrete choice experiment

Abstract

Objective To investigate preferences of pregnant women for the characteristics of prenatal testing, and to quantify their willingness‐to‐pay (WTP) for non‐invasive prenatal testing (NIPT) as first‐line screening for Down Syndrome. Method A cross‐sectional discrete choice experiment survey including five testing attributes was administered to 192 pregnant women (≤14 weeks' gestation) who were aged ≥21 years in Singapore. We calculated marginal WTP for improvements in testing characteristics and NIPT. Results We identified two groups of women with distinct preferences for prenatal testing. Women aged ≥35 years, with at least a university education, and with intention to terminate pregnancy of an affected fetus were more likely to be in the group with higher WTP for improvements in test characteristics. While participants valued increased detection rate and lower screen positive rate associated with NIPT, they also valued no risk of test failure and ability to test for birth defects using standard testing. The participants, on average, were not willing to pay for NIPT over the standard testing as a first‐line screening test. Conclusions As a first‐line screening, NIPT was not preferred over standard testing. The prenatal consultations should focus on each testing characteristic equally as our findings show diverse preferences for testing characteristics.

Insights Into Down Syndrome Screening and Diagnostic Test Preferences Among Pregnant Women: Findings from a Cross-Sectional Study in Vietnam

“…In contrast, another study from Singapore focusing on willingness-to-pay (WTP) for NIPT revealed that while older, more educated women, or those intending to terminate a pregnancy if affected, showed a higher WTP for NIPT, the general population was not willing to pay extra for NIPT over standard testing as a first-line screening method. This highlights a discrepancy between perceived value and actual financial commitment to NIPT in different cultural and economic settings, underscoring the complex dynamics that influence prenatal testing decisions globally (34).…”