Economic assessment of screening for pre-eclampsia

ABSTRACT Background Pre‐eclampsia is a major contributor to maternal and neonatal morbidity and mortality. Our objectives in this study are to economically assess, from the payer perspective, routine screening for pre‐eclampsia using placental markers ‐placental protein 13 and placental growth facto...

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Bibliographic Details
Published in:Prenatal diagnosis 2012-01, Vol.32 (1), p.29-38
Main Authors: Shmueli, Amir, Meiri, Hamutal, Gonen, Ron
Format: Article
Language:English
Subjects:
Adult
Cost of Illness
Cost-Benefit Analysis
Decision Support Techniques
diabetes
Diagnostic Tests, Routine - economics
Diagnostic Tests, Routine - methods
Doppler
early and late pre-eclampsia
Female
Health Care Costs
Humans
Models, Theoretical
PIGF
PP13
Pre-Eclampsia - diagnosis
Pre-Eclampsia - economics
Pre-Eclampsia - prevention & control
Pregnancy
Primary Prevention - economics
Primary Prevention - methods
QALY
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Summary:ABSTRACT Background Pre‐eclampsia is a major contributor to maternal and neonatal morbidity and mortality. Our objectives in this study are to economically assess, from the payer perspective, routine screening for pre‐eclampsia using placental markers ‐placental protein 13 and placental growth factor ‐ and uterine artery Doppler compared with standard care. Methods A decision model was developed, which progresses through three sequential endpoints, and compares screening with no screening: (1) Pre‐eclampsia yes/no: calculation of the incremental cost of pre‐eclampsia‐case averted; (2) Hospital discharge: calculation of the mean accumulated costs until discharge after delivery; and (3) Offspring death: calculation of the incremental cost per quality of life‐adjusted life‐year gained by screening. Data used includes: (1) Obstetrical data of 14 500 births; (2) cost data from the Israeli Ministry of Health and the literature; and (3) screening performance and outcome from the literature. Results (1) The incremental cost of pre‐eclampsia‐case averted is $66 949 and $24 723 when the prevalence is 1.7 and 5% respectively. (2) With test cost of $112, the total cost until discharge with/without screening is equal. With pre‐eclampsia prevalence of 3%, screening is cheaper. (3) The cost per quality of life‐adjusted life‐year with screening is $18 919 and 
ISSN:0197-3851
1097-0223
DOI:10.1002/pd.2871