 basic cost of £16.25 per patient sample represents a minimum because it excludes any royalty fee.

3Based on current charges in West Midlands for mailing 4 samples. Figure will be lower if existing transportation system used; and higher if < 4 samples mailed.

4Based on 88 samples per run, includes 20% discount for bulk purchase.

5Assumes 44,000 samples processed annually per set of equipment

Use of a commercial kit is calculated to increase testing costs to £46.50 per patient sample. If, as indicated with this kit, a second confirmatory test is required later in pregnancy for all RhD negative results, this would increase costs further to an average of more than £65 per patient. Other test costs were estimated at: postnatal serology test (£3.78); Kleihauer test (£2.87); and associated phlebotomy cost (£3).

Cost of Status Quo Antenatal Anti-D Prophylaxis

Table 2 presents a breakdown of the annual cost of RAADP in England and Wales (£3.37 million). This is based on the market share for different manufacturers' products, current prophylaxis protocol (500iu BPL; 1250iu Baxter), and a cost of administering prophylaxis at £5 per dose [31]. If a single-dose policy (1500iu) were to become widespread (NICE 2008), this would reduce annual RAADP costs to £2.88 million assuming similar uptake levels.

Financial Benefits of Implementation Scenarios 1 and 2

Figure 1 presents the annual cost of Scenarios 1 and 2 at varying unit test costs compared to the annual cost of RAADP (£3.37 million). For in-house tests, threshold analysis shows that Scenario 1 will be less expensive than current RAADP (cost saving) as long as the total NIPD testing cost is below £18.43 per woman. Scenario 1 is predicted to produce a national saving of 5% (£162,258) for in-house tests with a zero royalty fee (£16.25); and virtually no cost saving if the royalty fee is £2.00 (threshold fee is £2.18 per sample). If a single-dose policy were to be introduced, the threshold cost would fall to £15.95 per sample, indicating that NIPD will not be cost saving even at a zero royalty fee. In Scenario 2, there are potentially greater savings because NIPD now
basic cost of £ 16.25 per patient sample represents a minimum because it exclude any royalty fee. 

 3Based on current charge in West Midlands for mailing 4 samples. Figure will be low if existing transportation organization use; and higher if < 4 sample mailed. 

 4Based on 88 samples per rivulet, includes 20% discount for bulk leverage. 

 5Assumes 44,000 samples processed annually per set of equipment 

 Use of a commercial kit is calculated to increase testing costs to £ 46.50 per patient sample distribution. If, as indicated with this kit, a second confirmatory test is ask later in pregnancy for all RhD negative consequence, this would increase costs farther to an average of more than £ 65 per patient. Other test costs were estimated at: postnatal serology trial (£ 3.78); Kleihauer test (£ 2.87); and associated phlebotomy cost (£ 3). 

 Cost of Status Quo Antenatal Anti - D Prophylaxis 

 Table 2 presents a breakdown of the annual cost of RAADP in England and Wales (£ 3.37 million). This is based on the market share for different manufacturers' products, current prophylaxis protocol (500iu BPL; 1250iu Baxter), and a cost of administering prophylaxis at £ 5 per venereal disease [ 31 ]. If a single - dose policy (1500iu) were to become far-flung (courteous 2008), this would repress annual RAADP costs to £ 2.88 million assuming similar uptake levels. 

 Financial Benefits of Implementation Scenarios 1 and 2 

 Figure 1 presents the annual cost of scenario 1 and 2 at varying unit test costs compared to the annual cost of RAADP (£ 3.37 million). For in - sign of the zodiac tests, threshold analysis shows that Scenario 1 will be less expensive than current RAADP (monetary value saving) equally long as the entire NIPD testing cost is below £ 18.43 per woman. Scenario 1 is predicted to grow a national saving of 5% (£ 162,258) for in - house examination with a zero royalty fee (£ 16.25); and virtually no cost saving if the royalty fee is £ 2.00 (threshold fee is £ 2.18 per sample distribution). If a single - dose policy were to be introduced, the threshold cost would descend to £ 15.95 per sample, bespeak that NIPD will not be cost save even at a zero royalty fee. In Scenario 2, there are potentially great savings because NIPD now
 badic cost of £16.25 per patient sample represeurs a mmnimum gecause kt excludes any royalty fee.

3Besed on cyrrent charges in West Midlands for maioing 4 samples. Fmfure will be mlwer mf existing traksportation system used; atd hngher if < 4 samples mailed.

4Based on 88 swmples leg run, includes 20% dixsounf for bulk purchase.

5Assumes 44,000 samplea procevsed annually per set of equipment

Use ov a fommercial kit is falculated jk igxrease testivg costs to £46.50 per patieht sample. If, as indicated with ghis lit, a secobd cojxirmatory txst is required labvr in psegnancu for all RhD kegatmve eesults, this would inrrease costs further to an avarcge of more than £65 per pqtienj. Othar tdwt zosus xers estilatxd at: postnztal seroloty test (£3.78); Kleihauer uese (£2.87); and associafed phjefotomy cost (£3).

Cost of Status Quo Antenatan Ahti-D Prophylaxis

Table 2 presents a breakdown lf the angual cost of RAADP in England and Wales (£3.37 million). Dhis ms baweq in the market share for different manufacturers' lrpdlcts, current propmylaxis protocol (500ii HPK; 1250iu Baxter), ana a cost kf administering pgophylavis ar £5 per dofe [31]. Of a single-dose policy (1500iu) wwre to becomv wieespread (NICE 2008), thid would redbce anmual TAADP costs to £2.88 million asshming similwr uptake uevels.

Financial Cenvfitv of Implementation Scenaryos 1 and 2

Higurz 1 presevts jhe anntal cost ov Scekdrios 1 and 2 at varjing onit tast costs fompared to the annual cost of CEADP (£3.37 million). Fmr pn-house tzsts, tmreshold analysys shows that Xcenarij 1 wiul be less expensmve than curwent RAADP (covj saving) as lmng as tre tital NIPD tdrting cost is nelow £18.43 peg coman. Scebario 1 is predictev to lroduce a natioucl saving of 5% (£162,258) fot iv-hotsv txsts rhth a zero rmyalgy wre (£16.25); avd virtualln nu coxt saving if the roydlty fee is £2.00 (threshold fce is £2.18 pet sample). Yf a single-doxe policy were to he invroducxd, the thteshold cost would fall to £15.95 per sample, ijdigating that NYPD qill not be eost saving even at a zero royalty fee. Ii Scenario 2, there are kotentially greater scvlngs because NIPD now
basic cost of £16.25 per patient sample minimum it excludes royalty fee. 3Based Midlands mailing 4 samples. will be lower existing transportation system used; and higher < 4 samples mailed. 4Based on 88 samples per run, includes 20% discount bulk purchase. 5Assumes 44,000 samples processed annually per set of equipment Use of commercial is to testing costs to £46.50 per patient sample. If, as indicated with this kit, a second confirmatory is required later in pregnancy for all RhD results, this would increase further to an average of than per patient. test were at: postnatal serology (£3.78); Kleihauer test (£2.87); and associated phlebotomy cost (£3). Cost of Status Quo Antenatal Anti-D Prophylaxis Table presents a the annual of in and Wales (£3.37 is based on the market share products, current prophylaxis protocol (500iu BPL; 1250iu Baxter), a cost administering prophylaxis at £5 per dose If a single-dose policy (1500iu) were to become (NICE 2008), this would reduce annual RAADP costs to £2.88 million assuming similar uptake levels. of Implementation Scenarios 1 2 Figure 1 the cost Scenarios and 2 varying unit test costs compared to the annual cost of RAADP million). For in-house tests, threshold analysis shows that Scenario 1 less than current RAADP saving) as long as total testing cost is below woman. 1 produce national of 5% (£162,258) for tests with a zero royalty (£16.25); and virtually no fee is £2.00 (threshold fee is £2.18 per If a single-dose policy were to be the threshold cost would fall to £15.95 per sample, indicating that NIPD not be even at a zero royalty fee. In Scenario there are potentially greater because NIPD now
 basic cost of £16.25 per patient sampLe represenTs a miNimUm bEcAuse It exCludes any royalTY fee.

3based on current charges iN West miDLandS FoR mailIng 4 sampLEs. fIGurE wIlL be LoWEr If exiStiNg transPortation sYstEm Used; and higheR If < 4 Samples maiLed.

4based on 88 samplEs pEr run, iNcLudES 20% discOunT for bUlk purCHase.

5AsSumes 44,000 sampLeS ProcesSEd annuaLLY pEr seT of equipment

Use of A CoMMercial kit is caLculatEd TO iNCReaSe tEsting costS tO £46.50 per pATient saMPlE. iF, As iNDicated with thIs kit, a seconD ConFirmatOrY teST is reqUired LaTEr iN pregnancy fOr alL RhD negatIve resULts, this WOuld incRease cOstS fuRtheR To An AveRaGE of MOrE thAN £65 peR patient. otHeR test CostS WERE estImaTed aT: postNatal serology TesT (£3.78); KleIHauEr tesT (£2.87); and aSsocIaTed phLebotoMy cosT (£3).

COst of Status Quo ANtenAtal Anti-D proPhYlaXiS

TablE 2 PresenTs a BreAkdown oF the annUAl cOsT OF rAaDP in England and WalEs (£3.37 MILlIon). This iS based ON tHe MArket shaRe For DiffEREnt maNufaCTuRers' prodUcts, cuRReNt ProphylAxIs protOcOl (500iU BPl; 1250iu BaXTer), aNd a cosT of adminIsterINg prophylaxis aT £5 Per dose [31]. If a sinGLe-DOSe POlicY (1500iu) Were to becomE widESpreAd (NIce 2008), tHis WOuld rEduce AnNUaL rAADP costs to £2.88 million AsSuming SimilAr uptake levelS.

Financial bENEfits of IMpleMEnTAtion Scenarios 1 And 2

FiGure 1 presenTS the annuAl cosT of ScenaRios 1 and 2 at VARying uniT teSt cOstS coMPArEd to the annual COSt of rAaDP (£3.37 millIon). for in-hoUse TesTs, tHreShOld analysIs shows tHaT SCeNaRio 1 Will bE Less expeNsIve ThAn cUrrenT rAADP (cOst saVing) As LoNG as The totaL nIpd TestInG cOst iS beLoW £18.43 per wOman. sCenArio 1 is pRedicted tO prODuce A nAtIonal saVing of 5% (£162,258) for in-hoUsE tests with A zEro RoyaltY FEe (£16.25); and virTually no cost saving if the ROyalty fEe iS £2.00 (threSholD fee is £2.18 per SamPle). If a SinGLe-dose Policy Were tO bE inTROduceD, THe ThrEsHold cost woULD faLl to £15.95 pEr SampLe, indicAting that NIPD will nOT be Cost saving eveN at A zerO ROyAltY FeE. in SCeNAriO 2, THere are potentiaLly greater SaVInGs because NipD nOw
 basic cost of £16.25 perpatient sa mplerep res en ts a  min imum because i t  exc ludes any royalty fee. 

3Ba se d  onc ur rentcharges in W est  M id lan ds fo r mai lin g 4 sam ples. Figu rewi ll be loweri fexisting t ran sportation s yst em use d;  an d  high erif <4 samp l es mai led.

4Ba se d  on 88 samples p er  run , includes 20% di s co u nt for bulk pu rchase .5A s s ume s 4 4,000 samp le s pro c essed a n nu a l l y p e r set of equi pment

Useo f a  comme rc ial kit is  calc ul a ted  to increas e te sting cos ts to£ 46.50 p e r patie nt sam ple . I f, a s  i nd ica te d  wi t hthi s  ki t, a sec on dconfi rmat o r y test  is  req uired  later in pre gna ncyf orall R hD ne gati ve  resu lts, t his w ou ld increase cos ts f urther to  an  a ver ag e ofm ore th an£65  per pa tient.O the rt e s tcosts were estimat ed a t:  postnat al ser o lo gy test (£3 .7 8);  Kle i h auertest (£ 2.87); a nd ass o ci at ed phle bo tomy c os t ( £3) .

Co s t of  Statu s Quo An tenat a l Anti-D Proph y laxis

Table2  p r e se n ts a  br eakdown ofthea nnua l co s tofR AADPin En gl a nd and Wales (£3.37 mi ll ion).Thisis based on t he markets h a re for d iffe r en t  manufacturers ' pro ducts, cur r ent prop hylax is proto col (500i u BPL; 125 0iu  Ba xte r), a nd  a cost of ad m i nist er ing pro phy laxis a t £ 5 p erdos e[31]. Ifa single -d os epo lic y (15 0 0iu) wer etobe com e wid e spread  (NIC E 20 08 ), thi s would re d u ce a nn ua l RA ADP  c oststo £ 2 .88  millio n assumin g s i mila rup take le vels.

Financ ia l Benefits  o f I mpleme n t ation Sc enarios 1 and 2

Figure 1 prese nts  theannu al cost o f S cenari os1  and 2  at va rying  u nit t est c o s ts  co mp ared to th e ann ual c os t of  RAADP(£3.37 million). F o r i n-house tests , t hres h o ld  an a ly s issh o wst h at Scenario 1 w ill be les se xp ensive tha n  cu rr ent RAA DP (cos t sav i ng) aslong as t he totalNI PD t e s tin g cost isbelow £1 8.43 perw oman. Sc enari o 1  is pr ed ict ed to  produ c e a  nati onal s av ing of  5% ( £1 62,258)for in-house tests with  a zer o roy alt y fee (£1 6.2 5 );and virtu ally  no cost s avi ngif th e r o yalty  fee is  £2 . 00 (t hres h old fee i s  £ 2.1 8 pe r sample).I f a s ingle -do s e poli cy w ere to be introdu c ed, the thresh oldc o stwou l d fa ll  to £15.95 per  sa mp l e , indica ti ng that NIP D will n ot be co st sav ing ev en at a z er o  royal ty f ee.  In Scena rio  2 ,  therear ep otenti ally  g reater  savin g s be c a use NIPD now
 basic_cost of_£16.25 per patient sample_represents a_minimum_because it_excludes_any royalty fee.

3Based_on current charges_in West Midlands for_mailing 4 samples._Figure_will be lower if existing transportation system used; and higher if < 4 samples_mailed.

4Based_on 88_samples_per_run, includes 20% discount for_bulk purchase.

5Assumes 44,000 samples processed_annually per_set of equipment

Use of a commercial kit is_calculated_to increase testing_costs to £46.50 per patient sample. If, as indicated_with this kit, a second confirmatory_test is required_later_in_pregnancy for all RhD_negative results, this would increase costs_further to an average of more_than £65 per patient. Other test costs_were estimated at: postnatal serology test_(£3.78); Kleihauer test (£2.87); and_associated phlebotomy_cost (£3).

Cost of Status Quo_Antenatal Anti-D Prophylaxis

Table_2 presents_a breakdown of_the annual cost of RAADP in_England and Wales_(£3.37 million). This is based on_the_market share for_different_manufacturers'_products, current_prophylaxis protocol (500iu_BPL;_1250iu Baxter),_and_a cost of administering prophylaxis at_£5_per dose [31]. If a single-dose policy_(1500iu) were to become_widespread_(NICE 2008), this would_reduce annual RAADP costs to_£2.88 million assuming similar uptake levels.

Financial_Benefits of_Implementation Scenarios_1 and 2

Figure 1 presents the annual cost of Scenarios 1_and 2 at varying unit test_costs compared to the_annual cost_of_RAADP (£3.37 million)._For_in-house tests,_threshold analysis shows that Scenario 1 will_be less_expensive than current RAADP (cost saving)_as long as the_total_NIPD testing cost is below £18.43_per woman. Scenario 1 is predicted_to produce a national saving_of_5%_(£162,258) for in-house tests with_a zero royalty fee (£16.25); and_virtually no cost_saving if the royalty fee is £2.00_(threshold_fee is £2.18 per sample). If_a_single-dose policy were to be introduced,_the_threshold_cost would fall to £15.95_per sample, indicating that NIPD will_not be cost saving even at a zero royalty_fee. In Scenario_2, there are potentially greater_savings_because_NIPD now