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Model-Based Cost-Effectiveness Analysis of Routine Omega-3 Testing and Targeted Supplementation to Reduce Early
Hossein Haji Ali Afzali1, Ecushla Linedale1,2,3, Craig Martin4
1School of Public Health, Adelaide University, Adelaide, Australia.
Insights
Routine omega-3 testing and supplementation in early pregnancy can significantly reduce early preterm births. This strategy is cost-effective, preventing hundreds of births and saving millions in healthcare costs.
Area of Science:
- Obstetrics and Gynecology
- Nutritional Science
- Health Economics
Background:
- Preterm birth is a major global health concern, leading to infant mortality and long-term health issues.
- Omega-3 supplementation in early pregnancy can lower the risk of preterm birth, especially early preterm birth (<34 weeks).
- The economic impact of integrating omega-3 testing and supplementation into Australian antenatal care is not well understood.
Purpose of the Study:
- To evaluate the cost-effectiveness of routine omega-3 testing and targeted supplementation versus current practices in Australia.
- To model the potential reduction in early preterm births and associated healthcare cost savings.
Main Methods:
- A decision analytic model was developed using Australian data on epidemiology, clinical outcomes, and costs.
- The model projected outcomes over an 18-year period.
- Sensitivity analyses were performed to assess the impact of uncertainties in key model parameters.
Main Results:
- An estimated 17.5% of nearly 290,000 singleton pregnancies in 2022 were eligible for omega-3 supplementation.
- The model predicted that omega-3 testing and supplementation would prevent 640 early preterm births.
- This strategy was projected to save $26.1 million in direct healthcare costs, demonstrating a dominant economic advantage.
Conclusions:
- Omega-3 testing and targeted supplementation present a scalable, cost-effective approach to reducing early preterm birth.
- The strategy offers significant health benefits for mothers and infants, alongside economic advantages for the healthcare system.
- The modeled cost savings are robust, supporting the national implementation of this intervention.
Background:
Preterm birth remains a leading cause of newborn death, disability, and long-term health challenges globally, with a substantial impact on families, the health system, and society. Omega-3 supplementation in women with low omega-3 status in early pregnancy has been shown to reduce the risk of preterm birth, particularly early preterm birth (<34 weeks of gestation). The cost implications of incorporating omega-3 testing and targeted supplementation into routine antenatal care to reduce early preterm birth in Australia are unclear.
Methods:
A decision analytic model was developed using Australian epidemiological, clinical, and cost data to compare routine omega-3 testing and targeted supplementation with current practice. The model predicted the number of early preterm births prevented and associated cost savings over an 18-year time horizon. Deterministic sensitivity analyses were conducted to examine uncertainty in key model inputs.
Results:
Among 289,195 singleton pregnancies in 2022, an estimated 17.5% of women would have low omega-3 status and be eligible for supplementation. Making conservative assumptions, the model predicted that, relative to current practice, omega-3 testing and supplementation would be a dominant strategy, preventing 640 early preterm births, with projected savings of $26.1 million in direct healthcare costs. Sensitivity analyses indicated that the results were robust across most scenarios and identified the treatment effect estimate as the strongest driver of model predictions.
Conclusion:
Omega-3 testing in early pregnancy with targeted supplementation may offer a scalable and cost-effective strategy to reduce early preterm birth with potential benefits for mothers, infants, and the health system. The modelling suggests meaningful health and economic benefits. Cost savings were robust across most plausible scenarios, supporting the potential value of this approach on a national scale.
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