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Gestational diabetes screening with the new IADPSG guidelines: a cost-effectiveness analysis
John F Mission1, Mika S Ohno, Yvonne W Cheng
1Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA.
American Journal of Obstetrics and Gynecology
|July 31, 2012
Summary
Screening for gestational diabetes mellitus using the new International Association of Diabetes in Pregnancy Study Group (IADPSG) guidelines is cost effective. The 2-hour oral glucose tolerance test (OGTT) improves maternal and neonatal outcomes despite higher costs.
Area of Science:
- Reproductive Endocrinology
- Health Economics
- Maternal-Fetal Medicine
Background:
- Gestational diabetes mellitus (GDM) screening guidelines have evolved.
- The International Association of Diabetes in Pregnancy Study Group (IADPSG) has proposed new diagnostic criteria.
- Evaluating the cost-effectiveness of these new guidelines is crucial for healthcare resource allocation.
Purpose of the Study:
- To assess the cost-effectiveness of GDM screening using the IADPSG guidelines.
- To compare the 2-hour oral glucose tolerance test (OGTT) with the 1-hour glucose challenge test for GDM screening.
Main Methods:
- A decision analytic model was developed.
- Probabilities, costs, and benefits were sourced from existing literature.
- The model included base case analysis, sensitivity analyses, and Monte Carlo simulation.
Main Results:
- Screening with the 2-hour OGTT was found to be more effective and cost-effective at $61,503/quality-adjusted life year.
- The IADPSG approach remained cost-effective even with a 2.0% increase in diagnosed and treated GDM cases.
Conclusions:
- Screening for GDM using the 2-hour OGTT according to IADPSG guidelines is a cost-effective strategy.
- This approach improves maternal and neonatal outcomes.
- Further examination is needed on how healthcare systems can accommodate the expanded care required for this population.
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