疑わしい子癇前症に対するsFlt-1/PlGF比検査：オランダにおける経済的評価
E J Lodewijks1, M L E Hendrix1, J A P Bons2
1Department of Obstetrics & Gynecology, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands.
Objective:
This study aims to assess the economic impact of using the sFlt-1/PlGF ratio test in addition to standard care in women with suspected preeclampsia in a simulated cohort at Maastricht UMC in the Netherlands.
Study Design:
A decision tree model was developed to analyze the costs associated with introducing the sFlt-1/PlGF test. A theoretical cohort of 180 pregnant women with suspected preeclampsia was exposed to the test scenario, in which the sFlt-1/PlGF test was used in addition to current clinical practice, and to the no-testing scenario, in which clinical management was based on current clinical practice. Patient stratification into low-/intermediate- and high-intensity management groups was derived from the methodology used in the PROGNOSIS study, a non-interventional study for women with suspicion of preeclampsia. Follow-up and hospitalization length were derived from retrospective data, and costs were obtained from the Dutch Healthcare Authority. A sensitivity analysis tested the model's robustness, focusing on cost savings per patient as the primary outcome.
Main Outcome Measures:
Cost savings in euros for suspected preeclampsia patients and annual savings.
Results:
Integration of the sFlt-1/PlGF ratio in clinical practice is projected to generate an annual cost savings of €119 625 for Maastricht UMC. This is equivalent to €664 per patient, representing a cost reduction of 11.05 % in the test scenario compared to the no-testing scenario.
Conclusions:
Adopting the sFlt-1/PlGF ratio test for women with suspected preeclampsia is expected to result in cost savings in the Maastricht UMC. This can be explained by improved diagnostic accuracy and reduction of unnecessary hospitalization.
