down 's syndrome is an important congenital chromosomal disorder that can be seen around the world . this syndrome is the most common chromosomal disorder that the case can be alive for many years . however , the quality of life of the patient is usually poor due to the fact that all cases have mental retardation . the patients become the big problem of their families and can be the social burden . the antenatal screening for this disorder is an important processing in present obstetrics . in the past , it is suggested that any aged pregnant should get the screening for the down 's syndrome of the fetus in utero . however , this is not commonly used due to the invasive amniocentesis process . due to the concept of first the triple markers ( alpha - fetoprotein , human chorionic gonadotropin , and unconjugated estriol ) screening test has been introduced for a few years and acceptable for its efficacy . however , an important concern is on its cost - effectiveness . here , the author analyze and present the cost - effectiveness of the triple markers serum screening for down 's syndrome in thai setting . , the cost is assigned as the price of laboratory test quoted at the referencing laboratory in bangkok thailand ( special laboratory , bangkok , thailand ) . the effectiveness is assigned as reported effectiveness in screening or the diagnostic sensitivity , which is hereby referenced to the previously published paper from thailand . furthermore , the author uses the same cost - effectiveness analysis to assess the standard amniocentesis test as a standard comparison . according to this work , for the triple markers screening , the cost is equal to 100 us dollar and the effectiveness is equal to 85.7% . the derived is equal to 116.7 us dollar . for the standard amniocentesis , the cost is equal to 116.7 us dollar and the effectiveness is equal to 87.3% . it seems that the cost per effectiveness of triple marker serum screening is lower than that of standard amniocentesis test . to perform an antenatal test is the present concept in preventive fetal medicine . in case that the defected fetus is diagnosed , the consideration for therapeutic abortion might be considered . due to the high prevalence of down 's syndrome around the world , the attempt to perform an antenatal test is set around the world , including to thailand . there are several methods for screening down 's syndrome in thailand and the triple markers serum screening is also in use . it is no doubt that the diagnostic property of the triple markers serum screening is acceptable . some previous reports mentioned for the cost - effectiveness of using triple markers serum screening while the others mentioned that the test was not cost - effective . hence , to make a decision to implement this test in any setting , the evaluation for cost - effectiveness is needed . according to this work , the cost per effectiveness of triple markers serum screening is slightly lower than standard amniocentesis test . however in addition , due to the less invasiveness comparing to standard amniocentesis test , it is recommended to use triple markers serum screening for antenatal screening for down 's syndrome in thailand . in thai context , the triple markers serum screening is more cost - effective than standard amniocentesis test in screening for down 's syndrome .
background : down 's syndrome is an important congenital chromosomal disorder that can be seen around the world . the antenatal screening for this disorder is an important processing in present obstetrics.objective:due to the concept of first do no harm , the use of noninvasive test is recommended . 
 the triple marker screening test has been introduced for a few years and acceptable for its efficacy.result:however , an important concern is on its cost - effectiveness . here , 
 the author analyze and present the cost - effectiveness of the triple markers serum screening for down 's syndrome in thai setting.conclusion:according to this work , the cost per effectiveness of triple markers serum screening is slightly lower than standard amniocentesis test .