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What is the cost of NIPT?

What is the cost of NIPT?

This article is about the cost of NIPT.
NIPT is not available at all hospitals; there are licensed and unlicensed providers. The differences are as follows

What is the cost of NIPT?

NIPT has been available in Japan since 2013, but where can you actually get NIPT? I have heard on TV and the internet that it is expensive, but how much does it really cost? Can I use a deductible for medical expenses? Many people have questions such as, "Where can I get NIPT?

Below are some details about the cost of NIPT, which we hope you will find useful.

To undergo NIPT

NIPT is not available at all hospitals; there are licensed and unlicensed providers. The differences are as follows

 ApprovalUnapproved
Medical InstitutionInstitution accredited by the Japanese Medical Association and the Japan Society of Obstetrics and GynecologyNot a member of an academic society
CostCounseling and initial consultation fees are incurred in addition to the examination fee.
(Approx. 150,000-210,000 yen)
Slightly cheaper than approved because there may be no counseling or initial consultation fees, or in the case of a positive result, a separate amniotic fluid test fee may be required.
(Approx. 200,000 yen)
Counseling・As a general rule, couples should do this together.
・Conducted by qualified personnel
If not implemented, or find and receive it yourself at another facility.
Age limit35 years of age or older at birthNo age limit
Check condition・Possible chromosomal abnormalities on marker test or ultrasound
・Has a history of pregnancy or delivery of a baby with a chromosomal disorder.
・The applicant must meet one of the following conditions: ・Either of the parents has a chromosomal disease.

No inspection conditions
Checklist13.18.21 Trisomy13.18.21 Trisomy
Sex Chromosome Abnormality
Microchromosomal Microdeletion

Cost of inspection

The NIPT test process,

①Obstetrics outpatient visit

②Receive genetic counseling

③Blood sampling for NIPT test

④Explanation of test results

⑤Positive reaction or withholding of judgment requires a definitive test and an amniotic fluid chromosome test

⑥Explanation of amniotic fluid chromosome test results

and each has its own costs.

①Obstetrics outpatient visit

If the hospital you are visiting does not offer this service, you will need to go to a specific medical institution for consultation. In this case, an initial consultation fee will be charged, and the difference in cost is about 5,000 yen depending on whether or not you have a letter of referral. It also costs about 3,000 yen to have a letter of introduction written.

②Genetic Counseling

The counseling is conducted prior to the examination and, as a rule, is given together with the couple or partner.

  • Advantages and disadvantages of taking or not taking the test
  • What the test can and cannot tell you
  • The fact that NIPT is a non-confirmatory test and that amniocentesis and chorionic villus examination are necessary for a confirmatory test.
  • What symptoms a child born with a disease associated with a chromosomal abnormality may have.
  • The possibility of inheritance
  • Options for next steps depending on test results
  • The possible effects on the child of an older birth

Clinical geneticists and certified genetic counselors provide accurate information based on scientific evidence and consultation on such matters as the following.

③Blood sampling for NIPT test

After receiving genetic counseling, understanding, and obtaining written consent, testing (blood sampling) is performed. In the past, all tests were flown to the U.S. for analysis because testing and analysis could not be performed in Japan.

Some hospitals offer genetic counseling on the same day as the counseling, while others offer it again at a later date.

If the result is "negative," "positive," or "decision pending," and the decision pending (neither negative nor positive) continues, the patient must undergo another blood draw, and if positive, a definitive test.

Some hospitals also include the cost of counseling and an amniotic fluid test in the event of a positive result in this fee.

④Post-test genetic counseling

The results will be available approximately one to two weeks after the test, and another genetic counseling session will be conducted after the test as well. If the test is negative, the test is completed at this point, but it is explained that it is rare for a negative result to be found when the baby has an abnormality or a positive result when there is no abnormality, and that an amniotic fluid test is necessary to obtain a definite diagnosis.

⑤Amniotic fluid staining test

If the test result is positive, the patient must undergo another counseling session with a specialist and undergo an amniotic fluid test.

For the safety of the pregnant woman's body, the procedure is performed as a day trip or overnight stay in the hospital for two hours of bed rest after amniotic fluid collection.

*Virus Test

This is also done when a positive test is obtained with NIPT or when an obvious abnormality is found on ultrasound examination. A chorionic villus is extracted while confirming the position of the fetus by ultrasound.

Although it provides results earlier in the gestational weeks and more reliable results than amniotic fluid testing, amniotic fluid testing is often performed because of the risks to pregnant women, the difficulty of the technique, and the limited number of facilities that offer the test.

⑥Explanation of amniotic fluid chromosome test results

Results are available 2 to 4 weeks after the test.

Whether you are eligible for a medical expense deduction or subsidy

The medical expense deduction is a system that allows taxpayers to receive a partial refund for large medical expenses paid for illness or childbirth (when the total medical expenses for one year exceed 100,000 yen, or when the total medical expenses exceed 5% of income if income is less than 2 million yen). If your income is less than 2,000,000 yen, medical expenses exceed 5% of your income), a portion of your taxes will be refunded.

If it does not involve the treatment of a disease, such as a physical examination or medical checkup, it is not covered.

NIPT and amniotic fluid testing are a type of diagnostic procedure to check for abnormalities in the number of chromosomes in the fetus and are not therapeutic procedures, so they are not covered by the medical expense deductible. In addition, even if a positive test or chromosomal abnormality is found, it is not covered at this time because it does not lead directly to treatment.

However, transportation costs incurred for prenatal diagnosis are covered, as are transportation costs for hospital visits.

Medical insurance also covers hospitalization and surgery for treatment.

Therefore, hospitalization for amniotic fluid testing is not covered because it is not a therapeutic hospitalization.

Pregnancy examinations are partially or fully subsidized by the local government, but prenatal checkups are positioned differently and are not subsidized by the local government.

High medical expense is also a system that reimburses a portion of medical expenses if the monthly medical expenses exceed a certain amount in the health insurance plan to which you are enrolled. Prenatal checkups are also not covered by this system because medical insurance cannot be used for prenatal checkups.

Summary

NIPT is basically self-funded, and it is up to the individual to decide whether or not to take it.

At the present time, the test is not available at all medical facilities, but since the demand for the test has been increasing since NIPT was implemented due to the rise in the childbearing age, it is expected that more facilities will be able to provide the test in the future.

Many people are looking for a cheaper and quicker alternative, considering the possibility that they may not be able to get an appointment and may miss their scheduled cycle because of the limited number of facilities in their area or because they are not able to get an appointment at a facility that is approved. However, there are also some institutions that do not provide aftercare and only mail test results.

The fact that a medical institution is not accredited does not mean that it is illegal. Conditions for accreditation include having both an obstetrician and pediatrician with extensive knowledge and diagnosis on staff at all times, as well as having an outpatient clinic specializing in genetics.

The waiting time and cost burdens are significant, and we can only hope that there will be more appropriate facilities that will make it easier to receive the service in terms of both money and time.

Reference Data