Is the management of Rh-Rh incompatibility with noninvasive fetal Rh genotyping for targeted prophylaxis cost-effective in the Turkish population?
Background/aim:  The aim of this study was to assess unnecessary immunization rates and compare the cost-effectiveness of targeted prophylaxis with fetal Rh genotyping with that of traditional management of Rh-Rh incompatibility in a virtual economic model. 
Materials and methods: This retrospective data analysis was conducted at two tertiary centers between 2011 and 2015. The data of 1135 pregnant women were analyzed. The main outcome measure was to determine the unnecessary immunization rate among the whole Rh-Rh incompatibility group. The second outcome measure was to compare the cost-effectiveness of universal immunization with that of targeted prophylaxis with fetal Rh genotyping in a virtual economic model.
Results:  Average cost per patient was found as $259.20 with universal prophylaxis and the total cost was $177,344, whereas if targeted prophylaxis  had  been  applied  to  these  patients  the  total  cost  would  have  been  $263,392  and  cost  per  patient  would  have  been  $385.  Universal prophylaxis was more cost-effective than targeted prophylaxis in terms of both total cost and cost per patient (P < 0.0001).
Conclusion:  Unless the cost of noninvasive fetal Rh genotyping is reduced, a universal approach of anti-D immune globulin prophylaxis is more cost-effective than noninvasive determination of fetal Rh genotyping with targeted prophylaxis.
['Demirel|Emine|E|', 'Kelekçi|Sefa|S|', 'Ekmekci|Emre|E|', 'Şengül|Mustafa|M|', 'İri|Raziye|R|', 'Atasever|Melahat|M|']
D000328:Adult D003362:Cost-Benefit Analysis D005260:Female D005333:Fetus D005820:Genetic Testing D005838:Genotype D017048:Health Care Costs D006801:Humans D007155:Immunologic Factors D018803:Models, Economic D011247:Pregnancy D011295:Prenatal Care D012189:Retrospective Studies D012203:Rh Isoimmunization D018029:Rho(D) Immune Globulin D014421:Turkey
noninvasive Rh genotyping cost-effectiveness Anti-D prophylaxis cell-free DNA