Economic evaluation of sFlt-1/PlGF ratio test in pre-eclampsia prediction and diagnosis in two Brazilian hospitals

Figueira, Sarah Franco; Wolf, Cyrill; D'Innocenzo, M; Carvalho, João Paulo Venezian de; Barbosa, Mariana Granado; Zlotnik, Eduardo; Cordioli, Eduardo

doi:10.1016/j.preghy.2018.04.014

Cited by 14 publications

(15 citation statements)

References 22 publications

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“…In this study, we have shown a modest cost‐saving in comparison with other studies . Previous health economic studies of the implementation of PlGF testing in clinical care were based on hypothetical assumptions of reduction in resource use, with greater cost‐savings than we have presented in this analysis.…”

Section: Discussionmentioning

confidence: 58%

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Placental growth factor testing for suspected pre‐eclampsia: a cost‐effectiveness analysis

Duhig

Seed

Myers

et al. 2019

BJOG

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Objective To calculate the cost‐effectiveness of implementing PlGF testing alongside a clinical management algorithm in maternity services in the UK, compared with current standard care. Design Cost‐effectiveness analysis. Setting Eleven maternity units participating in the PARROT stepped‐wedge cluster‐randomised controlled trial. Population Women presenting with suspected pre‐eclampsia between 20+0 and 36+6 weeks’ gestation. Methods Monte Carlo simulation utilising resource use data and maternal adverse outcomes. Main outcome measures Cost per maternal adverse outcome prevented. Results Clinical care with PlGF testing costs less than current standard practice and resulted in fewer maternal adverse outcomes. There is a total cost‐saving of UK£149 per patient tested, when including the cost of the test. This represents a potential cost‐saving of UK£2,891,196 each year across the NHS in England. Conclusions Clinical care with PlGF testing is associated with the potential for cost‐savings per participant tested when compared with current practice via a reduction in outpatient attendances, and improves maternal outcomes. This economic analysis supports a role for implementation of PlGF testing in antenatal services for the assessment of women with suspected pre‐eclampsia. Tweetable abstract Placental growth factor testing for suspected pre‐eclampsia is cost‐saving and improves maternal outcomes.

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Section: Discussionmentioning

confidence: 58%

“…National guidelines have approved PlGF testing to rule out suspected pre‐eclampsia in the UK . Hypothetical economic models have found that PlGF‐based testing gives a cost‐saving of between £330 and £1032 per woman tested . These models have not examined trial data where use of PlGF has been incorporated into clinical care.…”

Section: Introductionmentioning

confidence: 99%

Placental growth factor testing for suspected pre‐eclampsia: a cost‐effectiveness analysis

Duhig

Seed

Myers

et al. 2019

BJOG

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“…PlGF, placental growth factor; PROGNOSIS, PRediction of short-term Outcomes in preGNant wOmen with Suspected preeclampsIa Study; sFlt-1, soluble fms-like tyrosine kinase-1 addition to its clinical performance. Similar research on the cost analysis of introducing the sFlt-1/PlGF ratio test has been performed using population-level data from PROG-NOSIS in the UK, Italy, Germany, Brazil, Switzerland, and the US [24][25][26][27][28][29][30]. In PROGNOSIS, the sFlt-1/PlGF ratio has been shown to improve the short-term prediction of preeclampsia in women with clinical suspicion of the condition, and NICE guidelines recommend the use of the sFlt-1/ PlGF ratio test to rule out preeclampsia, in addition to standard care, in women between 20 and 34 weeks + 6 days of gestation [35].…”

Section: Discussionmentioning

confidence: 99%

“…The economic impact of implementing the sFlt-1/PlGF ratio test, based on PROGNOSIS data, has been assessed in the UK, Italy, Brazil, Germany, Switzerland, and the US [24][25][26][27][28][29][30]. The authors concluded that introducing the test into clinical practice for women with suspected preeclampsia would provide cost savings for the respective healthcare providers, mainly due to the increased ability to rule out preeclampsia and thereby reduce unnecessary hospitalizations.…”

Section: Introductionmentioning

confidence: 99%

Economic evaluation of the sFlt-1/PlGF ratio for the short-term prediction of preeclampsia in a Japanese cohort of the PROGNOSIS Asia study

et al. 2021

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The PRediction of short-term Outcomes in preGNant wOmen with Suspected preeclampsIa Study (PROGNOSIS) Asia validated the use of the soluble fms-like tyrosine 1/placental growth factor (sFlt-1/PlGF) ratio cutoff value of ≤38 to rule out the occurrence of preeclampsia in the short term in Asian women. We assessed the economic impact of the introduction of the sFlt-1/PlGF ratio test for predicting preeclampsia in Japan using data from the Japanese cohort of PROGNOSIS Asia. The cost analysis was developed with estimates in either a no-test scenario, with clinical decisions based on standard diagnostic procedures alone, or a test scenario, in which the sFlt-1/PlGF ratio test was used in addition to standard diagnostic procedures. For both scenarios, rates of hospitalization and other test characteristics were obtained from the results for the Japanese cohort in PROGNOSIS Asia. The total cost per patient was the main outcome of this cost analysis model. Introduction of the sFlt-1/PlGF ratio test using a cutoff value of 38 resulted in a reduced hospitalization rate compared with the rate in the no-test scenario (14.4% versus 8.7%). The reduction in the rate of hospitalizations led to an estimated 16 373 JPY reduction in healthcare costs per patient. The sFlt-1/PlGF ratio test is likely to reduce the unnecessary hospitalization of women at low risk of developing preeclampsia in the short term while also identifying high-risk individuals requiring appropriate management. Reducing unnecessary hospitalizations would result in significant cost savings in the Japanese healthcare system.

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“…59 Other studies show similar findings. [60][61][62][63][64] These recent studies should also be compared with the findings…”

Section: Health Economicsmentioning

confidence: 96%

Maternal health and non‐communicable disease prevention: An investment case for the post COVID‐19 world and need for better health economic data

Kapur

Hod

2020

Intl J Gynecology & Obste

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An integrated approach to population health, disease surveillance, and preventive care will dominate the health agenda in the post COVID-19 world. Because of their huge burden and the vulnerability imposed during a health crisis, prevention and care of non-communicable diseases (NCDs) will need to be prioritized even further. Maternal and child health are inextricably linked with NCDs and their risk factors. The intergenerational impact of poor maternal nutrition and health conditions during pregnancy, particularly NCD-related pregnancy complications, can be considered as a multiplier of the ongoing pandemic of NCDs. The economic cost of poor maternal health and NCDrelated pregnancy complications is likely very high, but is not adequately researched or documented in the context of long-term population health. Interventions to address NCDs in pregnancy have beneficial effects on short-term pregnancy outcomes; but even more importantly, identifying "at-risk" mothers and offspring opens up the opportunity for targeted early preventive action. Preventive actions to address obesity, hypertension, type 2 diabetes, and cardiovascular diseases have a common lifestyle approachidentifying any one of these problems in pregnancy provides an opportunity to address them all. Cost-benefit analyses that only focus on the short-term and on one condition do not capture the full value of downstream, long-term benefits for population health.This requires urgent attention from FIGO. K E Y W O R D S

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Economic evaluation of sFlt-1/PlGF ratio test in pre-eclampsia prediction and diagnosis in two Brazilian hospitals

Abstract: The sFlt-1/PlGF ratio test has the potential to improve clinical decision-making and allocation of scarce resources by reducing unnecessary hospitalization of women at low risk of developing pre-eclampsia, and ensuring that women at higher risk are identified and managed appropriately.

Cited by 14 publications

References 22 publications

Placental growth factor testing for suspected pre‐eclampsia: a cost‐effectiveness analysis

Placental growth factor testing for suspected pre‐eclampsia: a cost‐effectiveness analysis

Economic evaluation of the sFlt-1/PlGF ratio for the short-term prediction of preeclampsia in a Japanese cohort of the PROGNOSIS Asia study

Maternal health and non‐communicable disease prevention: An investment case for the post COVID‐19 world and need for better health economic data

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