Cost-effectiveness of routine antenatal varicella screening

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Health Economics

Background:

• Varicella (chickenpox) poses risks during pregnancy.
• Screening pregnant women with unknown or negative varicella history is a potential preventive strategy.
• Evaluating the economic viability of such screening is crucial for healthcare resource allocation.

Purpose of the Study:

• To assess the cost-effectiveness of routine antenatal varicella serologic screening for pregnant women.
• To identify scenarios where such screening might become economically justifiable.

Main Methods:

• A decision analytic model was employed to simulate outcomes.
• Data on varicella cases, deaths, and life-years were used.
• Sensitivity analyses were conducted to explore variations in key parameters.

Main Results:

• Routine antenatal screening is not cost-effective under current conditions.
• Cost-effectiveness is achieved only with significantly reduced screening costs, higher exposure rates, or a reduced exposure risk for non-immune screened women.
• Integration into a universal adult screening and vaccination policy enhances cost-effectiveness.

Conclusions:

• Routine antenatal varicella screening is generally not cost-effective.
• Targeted screening in high-risk pregnant populations or as part of a broader adult immunization strategy may be justifiable.