There are several prenatal screening and diagnostic tests to detect fetal structural and chromosomal anomalies, classified as non-invasive and invasive methods. The regulation and financing of these examinations are heterogeneous across countries. On behalf of the Austrian Federal Ministry of Social Affairs, Health, Care and Consumer Protection, this policy brief focuses on the supply, financing and setting of the following tests in selected European countries: First Trimester Screening (FTS)/Combined Test (CT), Non-invasive Prenatal Test (NIPT), amniocentesis/chorionic villus sampling, and second-trimester ultrasound screening for fetal anomalies.

We chose six European countries to illustrate the range of possible regulations and forms of funding: Germany (DE), Switzerland (CH), the Netherlands (NL), United Kingdom (UK), Norway (NO) and Italy (IT). A comprehensive hand search was combined with an expert consultation by means of a questionnaire.

To answer the research questions, eleven completed questionnaires and 22 relevant sources from the hand search were available. The provision, regulation and financing of prenatal screening and diagnostic tests for fetal anomalies vary widely across the six selected countries. This concerns in particular the choice of the primary screening test for fetal trisomies (FTS/CT, NIPT or the identification of risk factors), the implementation of the NIPT, the reimbursement of the tests, the uptake of the examinations, but also the general antenatal care, especially the professional groups responsible for it. There are also similarities between countries, particularly concerning the provision and financing of invasive tests and the ultrasound screening for fetal anomalies in the second trimester.

In conclusion, it should be noted that due to the many ethical aspects of the topic, a broad societal discourse with the relevant interest groups and stakeholders appears to be necessary. Particular attention should be paid to high-quality and non-directive information and counselling.