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BJOG ; 126(11): 1390-1398, 2019 Oct.
Article in English | MEDLINE | ID: mdl-31240854

ABSTRACT

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.


Subject(s)
Diagnostic Techniques, Obstetrical and Gynecological/economics , Placenta Growth Factor/blood , Pre-Eclampsia/blood , Pre-Eclampsia/diagnosis , Pregnancy Complications/blood , Pregnancy Complications/diagnosis , Adult , Biomarkers/blood , Cluster Analysis , Cost-Benefit Analysis , Female , Gestational Age , Humans , Models, Economic , Pre-Eclampsia/epidemiology , Pre-Eclampsia/physiopathology , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/physiopathology , Pregnancy Outcome , United Kingdom/epidemiology
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