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Economic assessment of screening for pre-eclampsia.
MedLine Citation:
PMID:  22234821     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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 < $10 000 with pre-eclampsia prevalence of 1.7 and 3%, respectively. CONCLUSIONS: Screening for pre-eclampsia is cost-effective under various scenarios. Copyright © 2012 John Wiley & Sons, Ltd.
Authors:
Amir Shmueli; Hamutal Meiri; Ron Gonen
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-11
Journal Detail:
Title:  Prenatal diagnosis     Volume:  -     ISSN:  1097-0223     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 John Wiley & Sons, Ltd.
Affiliation:
Department of Health Management and Economics, Braun School of Public Health, The Hebrew University-Hadassah, Jerusalem, Israel.
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