Cost‐effectiveness of first‐trimester screening with early preventative use of aspirin in women at high risk of early‐onset pre‐eclampsia

Abstract

The implementation of a first trimester screening program for PE and intervention with aspirin in those identified as high risk of early PE has the potential to prevent a significant number of early onset PE cases with a substantial associated cost-savings to the health care system.

The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre‐eclampsia: A pragmatic guide for first‐trimester screening and prevention

“…Cost‐effectiveness of an early PE prediction and prevention approach has been evaluated in high‐income countries and has shown substantial cost saving . However, in low‐ and middle‐income countries, multiple system‐level barriers exist that impact implementation, evaluation, and sustainability of such approaches.…”

“…Prior to introducing first‐trimester screening for PE, a Canadian group examined the potential cost benefit of screening with aspirin prophylaxis in high‐risk women . The group used a decision analysis model assigning probabilities and associated costs at each node based on local published data and public databases.…”

FIGO (International Federation of Gynecology and Obstetrics) Postpregnancy Initiative: Long‐term Maternal Implications of Pregnancy Complications—Follow‐up Considerations

“…Use of novel biomarkers for pre‐eclampsia diagnosis has been shown to be cost‐effective . Using a decision analysis model, the clinical and economic benefits of a first‐trimester screening program based on the Fetal Medicine Foundation algorithm for prediction of early‐onset pre‐eclampsia coupled with early (<16 weeks) use of low‐dose aspirin in those at high risk was simulated and tested with current practice in Canada . Among the theoretical 387 516 births per year in Canada, the estimated prevalence of early‐onset pre‐eclampsia based on first‐trimester screening and aspirin use declined 1.5‐fold to 705 cases compared with 1801 cases based on current practice.…”

“…This resulted in an estimated saving of Can $13 130 per case averted (Can $14.39 million annually). Universal implementation of a first‐trimester screening program for pre‐eclampsia and early intervention with aspirin in women at high risk for early‐onset pre‐eclampsia has the potential to prevent a significant number of early‐onset pre‐eclampsia cases with a substantial cost savings to the healthcare system in Canada …”

“…187 Using a decision analysis model, the tion with aspirin in women at high risk for early-onset pre-eclampsia has the potential to prevent a significant number of early-onset preeclampsia cases with a substantial cost savings to the healthcare system in Canada. 188 A study from Nepal 189 showed the cost-effectiveness of a pilot project to provide calcium supplementation through the public sector to pregnant women during prenatal care, in addition to the existing practice for pre-eclampsia/eclampsia prevention.…”