Fetoscopic compared with open repair of myelomeningocele: a 2-delivery cost-effectiveness analysis

Packer, Claire H.; Hersh, Alyssa R.; Caughey, Aaron B.

doi:10.1016/j.ajogmf.2021.100434

Cited by 4 publications

(14 citation statements)

References 34 publications

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“…Only one study reported a discount rate of 3%. 25 Of the 13 eligible papers, 38.5% used a cost-effectiveness analysis (n = 5). 25 , 26 , 34 , 35 Eight studies employed a cost description analysis, 24 , 27–33 and only one study reported a decision tree model.…”

Section: Resultsmentioning

confidence: 99%

“…Packer et al reported that in a theoretical cohort of 500 patients, the fetoscopic surgical approach cost more than the open repair approach of MMC, however it was cost-effective with an incremental cost effectiveness ratio (ICER) of $1029 per QALY. 25 …”

Section: Resultsmentioning

confidence: 99%

“…Despite fetoscopic surgery being more costly than open fetal surgery, it also has benefits on future pregnancies, and long term outcomes in respect to the preterm birth risk, or uterine rupture. 25 …”

Section: Discussionmentioning

confidence: 99%

“…Packer et al, 2021 25 Werner et al, 2012 20 Lim et al, 2019 26 Sin et al, 2007 27 Harris et al, 2016 28 Pham et al, 2013 29 Bea et al, 1994 32 Hubbard et al, 2019 33 Liptak et al, 1985 24 Cartwright et al, 2019 34 Werner et al, 2012 Only one study reported a discount rate of 3%. 25 Of the 13 eligible papers, 38.5% used a cost-effectiveness analysis (n = 5). 25,26,34,35 Eight studies employed a cost description analysis, 24,[27][28][29][30][31][32][33] and only one study reported a decision tree model.…”

Section: Referencementioning

confidence: 99%

“…25 Of the 13 eligible papers, 38.5% used a cost-effectiveness analysis (n = 5). 25,26,34,35 Eight studies employed a cost description analysis, 24,[27][28][29][30][31][32][33] and only one study reported a decision tree model. 25 The time range of publications varied from 1985 to 2021.…”

Section: Referencementioning

confidence: 99%

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Pharmacoeconomic Evaluation of Costs of Myelomeningocele and Meningocele Treatment and Screening

Hoxha,

Malaj,

Zappacosta

et al. 2024

CEOR

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Background The prevention of myelomeningocele (MMC) and meningocele (MC) is a public health concern. A systematic review on economic factors associated with MMC and MC can help the policy makers to evaluate the cost-effectiveness of screening and treatment. To our knowledge, this is the first systematic review to provide up-to date pharmacoeconomic evidence of all economic studies present in literature on different aspects of MMC and MC. Methods We searched in the National Health Service Economic Evaluation Database (NHSEED), PubMed, Cost-effectiveness Analysis Registry (CEA Registry), Centre for Reviews and Dissemination (CRD), Health Technology Assessment Database (HTAD), Cochrane Library, and Econlit. The PRISMA guidelines were followed in the search and evaluation of literature. Only articles in English not limited by the year of publication that fulfilled the eligibility criteria were included in this systematic review. Results Nineteen papers were included in the study. The studies were very heterogeneous and reported a comparison of the costs between prenatal versus postnatal repair, the cost of fetoscopic approach versus open surgery, the cost of ventriculoperitoneal shunting (VPS) versus endoscopic third ventriculostomy (ETV), and ETV with choroid plexus cauterization (ETV/CPC), the cost of hospitalization, and the cost of diagnosis for MMC. Conclusion The results of this study can help in implementing new policies in different countries to assist MC and MMC patients with the cost of treatment and screening.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Referencementioning

confidence: 99%

Section: Referencementioning

confidence: 99%

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Pharmacoeconomic Evaluation of Costs of Myelomeningocele and Meningocele Treatment and Screening

Hoxha,

Malaj,

Zappacosta

et al. 2024

CEOR

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Fetal bradycardia in open versus fetoscopic prenatal repair of spina bifida

Papastefan,

Alhajjat,

Ott

et al. 2024

Prenatal Diagnosis

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ObjectiveTo compare the occurrence of fetal bradycardia in open versus fetoscopic fetal spina bifida surgery.MethodsThis is a single‐institution retrospective cohort study of patients undergoing open (n = 25) or fetoscopic (n = 26) spina bifida repair between 2017 and 2022. From October 2017 to June 2020, spina bifida repairs were performed via an open classical hysterotomy, and from November 2020 to June 2022 fetoscopic repairs were performed following transition to this technique. Fetal heart rate (FHR) in beats per minute (bpm) was recorded via echocardiography every 15 min during the procedure. Cohort characteristics, fetal bradycardia and maternal physiologic parameters were compared between the groups.ResultsFetuses undergoing an open repair more frequently developed bradycardia defined as <110 bpm (32% vs. 3.8%, p = 0.008), and a trend was observed for FHR decreases more than 25 bpm from baseline (20% vs. 3.8%, p = 0.073). Profound bradycardia less than 80 bpm was rare, occurring in only three operations (two in open, one in fetoscopic repair) with two fetuses (one in each group) requiring emergency cesarean delivery.ConclusionWhen compared to open fetal surgery, fetal bradycardia occurred less frequently in fetoscopic surgery despite a significantly greater anesthetic exposure and the use of the intraamniotic carbon dioxide insufflation.

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Fetal MRI prior to intrauterine surgery of open neural tube defects: What does the radiologist need to know

et al. 2022

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Fetoscopic compared with open repair of myelomeningocele: a 2-delivery cost-effectiveness analysis

Cited by 4 publications

References 34 publications

Pharmacoeconomic Evaluation of Costs of Myelomeningocele and Meningocele Treatment and Screening

Pharmacoeconomic Evaluation of Costs of Myelomeningocele and Meningocele Treatment and Screening

Fetal bradycardia in open versus fetoscopic prenatal repair of spina bifida

Fetal MRI prior to intrauterine surgery of open neural tube defects: What does the radiologist need to know

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