Economic assessment of screening for pre-eclampsia

Prenat Diagn. 2012 Jan;32(1):29-38. doi: 10.1002/pd.2871. Epub 2012 Jan 11.


Background: Pre-eclampsia is a major contributor to maternal and neonatal morbidity and mortality. Our objectives in this study are to economically assess, from the payer perspective, routine screening for pre-eclampsia using placental markers -placental protein 13 and placental growth factor - and uterine artery Doppler compared with standard care.

Methods: A decision model was developed, which progresses through three sequential endpoints, and compares screening with no screening: (1) Pre-eclampsia yes/no: calculation of the incremental cost of pre-eclampsia-case averted; (2) Hospital discharge: calculation of the mean accumulated costs until discharge after delivery; and (3) Offspring death: calculation of the incremental cost per quality of life-adjusted life-year gained by screening. Data used includes: (1) Obstetrical data of 14 500 births; (2) cost data from the Israeli Ministry of Health and the literature; and (3) screening performance and outcome from the literature.

Results: (1) The incremental cost of pre-eclampsia-case averted is $66,949 and $24,723 when the prevalence is 1.7 and 5% respectively. (2) With test cost of $112, the total cost until discharge with/without screening is equal. With pre-eclampsia prevalence of 3%, screening is cheaper. (3) The cost per quality of life-adjusted life-year with screening is $18,919 and < $10,000 with pre-eclampsia prevalence of 1.7 and 3%, respectively.

Conclusions: Screening for pre-eclampsia is cost-effective under various scenarios.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cost of Illness
  • Cost-Benefit Analysis
  • Decision Support Techniques
  • Diagnostic Tests, Routine / economics*
  • Diagnostic Tests, Routine / methods
  • Female
  • Health Care Costs*
  • Humans
  • Models, Theoretical
  • Pre-Eclampsia / diagnosis
  • Pre-Eclampsia / economics*
  • Pre-Eclampsia / prevention & control
  • Pregnancy
  • Primary Prevention / economics
  • Primary Prevention / methods*