Economic assessment of screening for pre-eclampsia

Amir Shmueli, Hamutal Meiri, Ron Gonen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

60 Scopus citations

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 $66949 and $24723 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 $18919 and<$10000 with pre-eclampsia prevalence of 1.7 and 3%, respectively. Conclusions: Screening for pre-eclampsia is cost-effective under various scenarios.

Original languageEnglish
Pages (from-to)29-38
Number of pages10
JournalPrenatal Diagnosis
Volume32
Issue number1
DOIs
StatePublished - Jan 2012
Externally publishedYes

Keywords

  • Diabetes
  • Doppler
  • Early and late pre-eclampsia
  • PIGF
  • PP13
  • QALY

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