Non-invasive prenatal screening (NIPT) global market pattern

US and European NIPT market conditions

In the United States, the NIPT market is mainly covered by four companies, Sequenom, Verinata Health (acquired by Illumina in 2013), and Ariosa Diagnostics and Natera's corresponding NIPT products are also marketed at the end of 2011 to the end of 2012 [1]. During this period, the NIPT commercialization model officially kicked off.

From the detection technology, the companies that provide NIPT services are mainly divided into two categories, 1) Sequenom and Verinata using high-throughput whole-genome sequencing to detect samples, and 2) targeted region sequencing for chromosomes. Ariosa and Natera for ploidy analysis. Due to the different segment sizes selected for chromosome polyploidy analysis, the amount of sequencing data required is not the same. The detection products provided by Sequenom and Verinata using high-throughput whole-genome sequencing methods require a relatively large amount of sequencing data, and the number of Reads required for each sample needs to reach more than 13 million [2,3]. In his research, Christina Fan described "the use of high-throughput whole-genome sequencing for NIPT detection. The sensitivity and accuracy of the assay is directly related to the amount of data. It is recommended to use data with a read number greater than 10M for detection and analysis" [4]. Ariosa and Natera, which obtain ploidy information by targeting regional information, require relatively little sequencing throughput, which requires sequencing sequences of 1.1 M and 6.5 M, respectively [5,6]. In the selection of sequencing platforms, these companies have chosen the HiSeq2000 (Illumina) sequencing platform with high throughput and low cost of sequencing [2, 7, 8, 9]. Regardless of the technical route, all four companies have verified the credibility of their test results and reported high-confidence test results ranging from hundreds to thousands in the corresponding academic journals. 1) [2, 3, 7, 8, 10, 11]. In the inspection cycle, except for Natera, which takes 15 days, all three other companies need 8-10 days to complete the test [1].

From the point of view of regulators surface, four companies have received CAP (College of American Pathologists) and CLIA (clinical laboratory improvement amendments) certification, and Sequenom and Verinata plans to submit IVD (in vitro diagnostic products), Application for PMA ( approval management before listing ) [1]. In addition, illumina is planning to submit a HiSeq 2500 NIPT test kit to the FDA at the end of this year after obtaining FDA approval from MiSeqDx [12]. If approved, it will be of great significance for the establishment and improvement of the entire industry standard.

In terms of payment, most NIPT testing companies in the United States use two methods, either at their own expense or in the form of personal and insurance contributions. The fees that individuals pay at their own expense range from $295 to $1,700. NIPT Service Company of the United States actively seeks to cooperate with insurance companies [1], Genomeweb reported on February 19 this year: Verinata has received 130 million insurance contracts in the United States, and Sequenom has also received insurance contracts of 113 million. ].

           In Europe, the NIPT market is dominated by a company, LifeCodexx [14]. The company is the only European NIPT IVDD (In vitro diagnostics directive) certified company. The company collaborated with Sequenom, and the technology route adopted Sequenom's high-throughput whole-genome sequencing method. The single-sample test data volume reached 10-30M [15], and the test cost required 985 euros.

Table 1: Overview of foreign NIPT companies

Note: CLIA, clinical laboratory improvement amendments; CAP, College of American Pathologists; IVD, in vitro diagnostic products; IVDD, in vitro diagnostic directive (Europe); PMA, premarket approval management; SNP, single-core Glycosidic acid polymorphism .

China's NIPT market conditions

China's NIPT market is dominated by two companies, namely BGI and Berry and Kang. The detection products have been listed since the end of 2012. The detection technology route adopted is a high-throughput whole-genome sequencing method, and the corresponding literature also reports on its technical route. Among them, BGI tested 11263 samples and completed detection with GAIIx and HiSeq2000 [18]. During the detection process, one sample of HiSeq2000 detected 12 samples, and the data volume of a single sample was about 15M. Berry and Kang conducted two clinical trials, the first phase completed 435 samples [19], and the second phase completed 1916 samples [20]. The technical route and the amount of sequencing data are similar to those of BGI. High-throughput whole-genome sequencing is also used, and 12 pairs of samples are detected using a Lane on the HiSeq2000 platform. At the beginning of this year, Aijian Biotech's Aijian Biotech used Themo Fisher's Proton sequencing platform to complete the pre-sample test. In its corresponding research paper, it was mentioned that 2275 samples have been tested [21], and the needs of each sample The amount of data is about 5.6M reads.

Regarding the detection price, the domestic NIPT sample testing terminal price is 280-560 US dollars [22], different companies and different regions will be slightly different. As far as the regulatory situation is concerned, China's NIPT market is in the process of increasing market standardization. With the gradual opening of the pilot application, China's NIPT industry will usher in explosive growth. Some media also pointed out that BGI is using the Complete genomes and Ion Proton platform for domestic SFDA applications, and hopes to obtain approval through the acquisition of foreign companies and OEM. The other two companies, Berry and Kang and Aijian Bio, sought to work with Illumina and Themo Fisher to obtain regulatory approvals [23].

Table 2: Overview of China's NIPT market situation

*Based on its official publication of non-invasive prenatal diagnostic papers and the sequencing platform used in the paper

Differences between NIPT companies and foreign companies in China

Like the foreign NIPT market, domestic companies almost all use high-throughput whole-genome sequencing to carry out NIPT services. The detection platform is mainly based on the Illumina sequencing platform. Illumina is basically in a market monopoly position. However, local companies are boldly trying differently. The technical route, if Aijian Bio chooses Theo Fisher (formerly LIFE Technologies)'s Ion Proton platform to develop its test products, but due to the limited instrument throughput, it can only be detected by a method that greatly reduces the number of reads , but because of its start Later, the accumulated clinical data is limited, and the reliability and cost have yet to be tested by the market. If the method of the number of reads is feasible, because illumina has a huge advantage in terms of throughput and throughput, the cost of NIPT detection may be further reduced, which is undoubtedly more for the pregnant women, the development of the industry. favorable. From the point of view of product launch time, although NIPT companies launched products a year later than American companies, they are developing rapidly and new enterprises are emerging. This also leads to the lack of clear industry standards in the NIPT market. There is no clear threshold for enterprises, and the supervision of such enterprises is small. These problems directly lead to the suspension of the gene clinical service testing by the Health Planning Commission. Later, with the opening of the pilot, the continuous improvement of industry standards, and the constraints and management of the new laws and regulations on the NIPT industry, will contribute to the healthy, stable and sustainable development of the entire NIPT industry in China.

references:

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[4] Fan HC, Quake SR. Sensitivity of Noninvasive Prenatal Detection of Fetal Aneuploidy from Maternal Plasma Using Shotgun Sequencing Is Limited Only by Counting Statistics. PLoS One. 2010 May 3;5(5):e10439. doi: 10.1371/journal. Pone.0010439.

[5] Norton ME, Brar H, Weiss J, et al. Non-Invasive Chromosomal Evaluation (NICE) Study: results of a multicenter prospective cohort study for detection of fetal trisomy 21 and trisomy 18. Am J ObstetGynecol 2012;207:137 .e1-8.

[6] Nicolaides KH, Syngelaki A, Gil M, Atanasova V, Markova D.Validation of targeted sequencing of single-nucleotide polymorphisms for non-invasive prenatal detection of aneuploidy of chromosomes 13, 18, 21, X, and Y. PrenatDiagn. 2013 Jun;33(6):575-9. doi: 10.1002/pd.4103. Epub 2013 Apr 24.

[7 ] Futch T, Spinosa J, Bhatt S, de Feo E, Rava RP, Sehnert AJ.nitial clinical laboratory experience in noninvasive prenatal testing for fetal aneuploidy from maternal plasma DNA samples. PrenatDiagn. 2013 Jun;33(6):569 -74. doi: 10.1002/pd.4123.

[8] Norton ME1, Brar H, Weiss J, Karimi A, et al, Non-Invasive Chromosomal Evaluation (NICE) Study: results of a multicenter prospective cohort study for detection of fetal trisomy 21 and trisomy 18. Am J Obstet Gynecol. 2012 Aug;207(2):137.e1-8. doi: 10.1016/j.ajog.2012.05.021. Epub 2012 Jun 1.

[9] Zimmermann B , Hill M, Gemelos G, Demko Z et al, Noninvasive   Prenatal   Aneuploidy   Testing   Of   Chromosomes   13 ,   18 ,   21 ,   X , and   Y , using   Targeted   Align   Of polymorphic   . loci PrenatDiagn 2012 Dec; 32 ( 13):. 1233-41 doi: 10.1002 / pd.3993 Epub 2012 Oct 30...

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[17] Nicolaides KH, Syngelaki A, Gil M, Atanasova V, Markova D.Validation of potential sequencing of single-nucleotide polymorphisms for non-invasive prenatal detection of aneuploidy of chromosomes 13, 18, 21, X, and Y. PrenatDiagn. 2013 Jun;33(6):575-9. doi: 10.1002/pd.4103. Epub 2013 Apr 24.

[18] Dan S1, Wang W, Ren J, Li Y, et.al, Clinical application of massively parallel sequencing-based prenatal noninvasive fetal trisomy test for trisomies 21 and 18 in 11,105 pregnancies with mixed risk factors. PrenatDiagn. 2012 Dec; 32(13): 1225-32. doi: 10.1002/pd.4002. Epub 2012 Nov 9.

[19] Desheng Liang, Weigang Lv, et al. Non-invasive prenatal testing of fetal whole chromosome aneuploidy by massively parallel sequencing. PrenatDiagn 2013 , 32:1-7.

[20] Yijun Song, Congcong Liu, et al. Non Invasive Prenatal Testing of Fetal Aneuploidies by Massively Parallel Sequencing in a Prospective Chinese Population. PrenatDiagn . 2013. Doi: 10.1002/pd.4160

[21] Liao C, Yin AH, Peng CF, Fu F, et al. Noninvasive prenataldiagnosis of commonaneuploidies by semiconductor sequencing. ProcNatlAcadSci US A. 2014 May 20;111(20):7415-20. doi: 10.1073/pnas.1321997111. Epub 2014 May 5.

[22] http://?page=3

[23] http://360zhyx.com/article-2263-1.html

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