Cost-Effectiveness of a Proteomic Test for Preterm Birth Prediction

Area of Science:

• Reproductive Health
• Maternal-Fetal Medicine
• Health Economics

Background:

• Preterm birth (PTB) is a major cause of infant mortality and morbidity, associated with significant healthcare expenditures.
• Current methods for identifying PTB risk are insufficient, failing to detect a majority of cases.

Purpose of the Study:

• To evaluate the cost-effectiveness of a novel risk-screening-and-treat strategy for PTB prevention in commercially insured pregnant women.
• The strategy involves a prognostic blood test (PreTRM®) and targeted treatment for high-risk individuals.

Main Methods:

• A cost-effectiveness model using a decision-tree/Markov approach from a US payer perspective.
• Data from >40,000 mother-infant pairs were used to estimate PTB rates and costs.
• Model inputs for test performance and treatment effectiveness were derived from published literature.

Main Results:

• The risk-screening-and-treat strategy demonstrated cost-effectiveness, reducing PTBs by 20% (870 fewer) and saving $54 million.
• Projected reductions include 10% in neonatal intensive care admissions and 33% in very preterm births (<32 weeks).
• Treatment effectiveness was the primary driver of cost-effectiveness outcomes.

Conclusions:

• Implementing a prognostic PTB test with evidence-based treatment is cost-effective.
• This strategy reduces overall healthcare costs while preventing preterm births and their adverse consequences.