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Published on: January 12, 2018
17alpha-hydroxyprogesterone caproate for the prevention of preterm delivery: A cost-effectiveness analysis
Anthony O Odibo1, David M Stamilio, George A Macones
1Department of Obstetrics and Gynecology, Center for Clinical Epidemiology and Biostatistics, Internal Medicine and Health Management Systems, Washington University Medical Center in St. Louis, Missouri 63110, USA. odiboa@wudosis.wustl.edu
Objective:
To evaluate whether the use of 17alpha-hydroxyprogesterone caproate for the prevention of recurrent preterm deliveries is cost-effective.
Methods:
Using decision-analysis modeling, we compared the cost-effectiveness of using 17alpha-hydroxyprogesterone caproate in four subgroups: 1) Prior preterm deliveries less than 32 weeks; 2) prior preterm deliveries 32-37 weeks; 3) prior term delivery; and 4) no prior delivery. Each subgroup was compared with a "no treatment" group. Costs included those for 17alpha-hydroxyprogesterone caproate, hospital admissions, and complications from preterm deliveries. The main outcome measures include cost per quality-adjusted life-year gained and the number of preterm deliveries prevented. Secondary outcomes include neonatal complications prevented. One-way and multiway sensitivity analyses were performed.
Results:
The use of 17alpha-hydroxyprogesterone caproate for the prevention of preterm deliveries result in cost-savings in women with prior preterm deliveries less than 32 weeks and 32-37 weeks. The sensitivity analyses revealed the model to be robust over a wide range of values for evaluated variables.
Conclusion:
Within our baseline assumptions, 17alpha-hydroxyprogesterone caproate was associated with cost-savings when used for the prevention of preterm deliveries in women with prior preterm deliveries.
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