Willingness to accept and pay for expanded new-generation non-invasive prenatal testing in China: a web-based cross-sectional survey
Chi Zhang, Zeyu Tan, Nan Zhang, Zichun Zhou, Fuming Li, Yingyao ChenIntroduction
New-generation non-invasive prenatal testing (NIPT 2.0) has expanded detectable conditions and is increasingly available in China, yet research on public acceptance and willingness to pay (WTP) remains limited.
Methods
In July 2025, men and women of reproductive age with fertility intentions recruited online were randomly assigned to high- or low-price scenarios. Sociodemographic characteristics, genetic knowledge and attitudes towards genetic testing were collected. After contextual information was provided, acceptance of NIPT 2.0 under a hypothetical pregnancy was assessed. Among those willing to accept, out-of-pocket WTP was elicited using multiple-bounded dichotomous choices and an open-ended question. Logistic regression, parametric survival models and linear regression examined associated factors.
Results
Among 419 responses, 384 (91.65%) indicated acceptance of NIPT 2.0; lack of basic medical insurance and lower genetic knowledge were associated with lower acceptance. For interval-censored WTP, the estimated median was ¥3664.12 (US$519.73), while mean estimates were sensitive to model assumptions; higher price anchoring and uncertain family history of birth defects were negatively associated with WTP. For open-ended WTP, the estimated median and mean were ¥5000.00 (US$709.22) and ¥4663.31 (US$661.46), respectively; higher price anchoring, having no children and greater risk concerns were positively associated with WTP, whereas uncertainty about family history of birth defects was negatively associated.
Conclusions
A high level of stated acceptance was observed in our sample and WTP exceeded current prices. Both outcomes are associated with a range of socio-economic and cognitive factors. These findings offer preliminary insights into public perceptions of NIPT 2.0 in China.