Display options
Cite
Khosla K, Espinoza J, Perlaza L, et al. Cost effectiveness of the sFlt1/PlGF ratio test as an adjunct to the current practice of evaluating suspected preeclampsia in the United States. Pregnancy Hypertens. 2021;26:121-126doi: 10.1016/j.preghy.2021.10.009.
Khosla, K., Espinoza, J., Perlaza, L., Gencay, M., Mueller, A. L., Harris, J. M., Wolf, C., Posnett, J. W., Woelkers, D. A., & Rana, S. (2021). Cost effectiveness of the sFlt1/PlGF ratio test as an adjunct to the current practice of evaluating suspected preeclampsia in the United States. Pregnancy hypertension, 26121-126. https://doi.org/10.1016/j.preghy.2021.10.009
Khosla, Kavia, et al. "Cost effectiveness of the sFlt1/PlGF ratio test as an adjunct to the current practice of evaluating suspected preeclampsia in the United States." Pregnancy hypertension vol. 26 (2021): 121-126. doi: https://doi.org/10.1016/j.preghy.2021.10.009
Khosla K, Espinoza J, Perlaza L, Gencay M, Mueller AL, Harris JM, Wolf C, Posnett JW, Woelkers DA, Rana S. Cost effectiveness of the sFlt1/PlGF ratio test as an adjunct to the current practice of evaluating suspected preeclampsia in the United States. Pregnancy Hypertens. 2021 Dec;26:121-126. doi: 10.1016/j.preghy.2021.10.009. Epub 2021 Oct 29. PMID: 34749060.
Copy Download .nbib Format: NLM
Share it on

Pregnancy Hypertens. 2021 Dec;26:121-126. doi: 10.1016/j.preghy.2021.10.009. Epub 2021 Oct 29.

Cost effectiveness of the sFlt1/PlGF ratio test as an adjunct to the current practice of evaluating suspected preeclampsia in the United States.

Pregnancy hypertension

Kavia Khosla, Jimmy Espinoza, Lauren Perlaza, Mikael Gencay, Ariel L Mueller, James M Harris, Cyrill Wolf, John W Posnett, Douglas A Woelkers, Sarosh Rana

Affiliations

  1. University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
  2. Department of Obstetrics & Gynecology, Division of Fetal Therapy and Surgery, Baylor College of Medicine, Houston, TX, USA.
  3. Roche Diagnostics, Indianapolis, IN, USA.
  4. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  5. Roche Diagnostics International Ltd, Rotkreuz, Switzerland.
  6. PAREXEL International, London, UK.
  7. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Diego School of Medicine, San Diego, CA, USA.
  8. Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Chicago, Chicago, IL, USA. Electronic address: [email protected].

PMID: 34749060 DOI: 10.1016/j.preghy.2021.10.009

Abstract

OBJECTIVE: Preeclampsia is a major obstetric disorder that can lead to severe maternal, fetal and infant outcomes. In women with suspected preeclampsia, measurement of the soluble fms-like tyrosine kinase-1 (sFlt1) and placental growth factor (PlGF) ratio has been shown to have a high negative predictive value (>97%). Our aim was to estimate the value to the US healthcare system of adopting this test into clinical practice.

STUDY DESIGN: An economic model was developed for the evaluation of suspected preeclampsia from a US payer perspective using data from a US observational study of 459 women evaluated between 23 and 34.6 weeks. Test results were not available to clinicians. The model compares two strategies for managing suspected preeclampsia: standard care versus a biomarker-informed pathway utilizing the sFlt1/PlGF ratio.

RESULTS: Utilization of the sFlt1/PlGF ratio test reduced the number of women admitted for suspected preeclampsia by 34-49%. Despite fewer admissions, a higher proportion of women admitted to hospital subsequently developed preeclampsia, and the proportion of women not admitted who would subsequently develop preeclampsia remained low (3.2%-6.7%). Cost savings arising from a reduction in admissions are estimated to be $1050 in the base case; varying the hospitalization cost ±25% would lead to savings in the range $771 to $1330 per patient at 2020 prices.

CONCLUSION: Adopting the sFlt1/PlGF ratio test as an adjunct to clinical criteria improves the assessment of risk in women presenting with suspicion of preeclampsia and has the potential to safely reduce unnecessary admissions and save costs.

Copyright © 2021 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

Keywords: Cost effectiveness; Preeclampsia; United States; sFlt/PlGF ratio

Publication Types