{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T09:17:27Z","timestamp":1787563047849,"version":"build-2736575974"},"reference-count":55,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T00:00:00Z","timestamp":1644969600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We sought to determine the cost\u2010effectiveness of noninvasive fetal RhD blood group genotyping in nonalloimmunized and alloimmunized pregnancies in Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design and methods<\/jats:title>\n                    <jats:p>We developed two probabilistic state\u2010transition (Markov) microsimulation models to compare fetal genotyping followed by targeted management versus usual care (i.e., universal Rh immunoglobulin [RhIG] prophylaxis in nonalloimmunized RhD\u2010negative pregnancies, or universal intensive monitoring in alloimmunized pregnancies). The reference case considered a healthcare payer perspective and a 10\u2010year time horizon. Sensitivity analysis examined assumptions related to test cost, paternal screening, subsequent pregnancies, other alloantibodies (e.g., K, Rh c\/C\/E), societal perspective, and lifetime horizon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fetal genotyping in nonalloimmunized pregnancies (at per\u2010sample test cost of C$247\/US$311) was associated with a slightly higher probability of maternal alloimmunization (22 vs. 21 per 10,000) and a reduced number of RhIG injections (1.427 vs. 1.795) than usual care. It was more expensive (C$154\/US$194, 95% Credible Interval [CrI]: C$139\/US$175\u2010C$169\/US$213) and had little impact on QALYs (0.0007, 95%CrI: \u22120.01\u20130.01). These results were sensitive to the test cost (threshold achieved at C$88\/US$111), and inclusion of paternal screening. Fetal genotyping in alloimmunized pregnancies (at test cost of C$328\/US$413) was less expensive (\u2010C$6280\/US$7903, 95% CrI: \u2010C$6325\/US$7959 to \u2010C$6229\/US$7838) and more effective (0.19 QALYs, 95% CrI 0.17\u20130.20) than usual care. These cost savings remained robust in sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Noninvasive fetal RhD genotyping saves resources and represents good value for the management of alloimmunized pregnancies. If the cost of genotyping is substantially decreased, the targeted intervention can become a viable option for nonalloimmunized pregnancies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.16826","type":"journal-article","created":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T04:06:03Z","timestamp":1644984363000},"page":"1089-1102","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["<scp>Cost\u2010effectiveness<\/scp>\n                    of noninvasive fetal\n                    <scp>RhD<\/scp>\n                    blood group genotyping in nonalloimmunized and alloimmunized pregnancies"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5024-1641","authenticated-orcid":false,"given":"Olga","family":"Gajic\u2010Veljanoski","sequence":"first","affiliation":[{"name":"Ontario Health (Clinical Institutes and Quality Programs\/Health Technology Assessment)  Toronto 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