sFlt-1/PlGF ratio test for pre-eclampsia: an economic assessment for the UK

Ultrasound Obstet Gynecol. 2016 Dec;48(6):765-771. doi: 10.1002/uog.15997. Epub 2016 Nov 8.

Abstract

Objectives: To assess the economic impact of introducing into clinical practice in the UK the soluble fms-like tyrosine kinase (sFlt-1) to placental growth factor (PlGF) ratio test for guiding the management of pre-eclampsia.

Methods: We used an economic model estimating the incremental value of information, from a UK National Health Service payer's perspective, generated by the sFlt-1/PlGF ratio test, compared with current diagnostic procedures, in guiding the management of women with suspected pre-eclampsia. The economic model estimated costs associated with the diagnosis and management of pre-eclampsia in pregnant women between 24 + 0 and 36 + 6 weeks' gestation, managed in either a 'test' scenario in which the sFlt-1/PlGF test is used in addition to current diagnostic procedures, or a 'no-test' scenario in which clinical decisions are based on current diagnostic procedures alone. Test characteristics and resource use were derived from PROGNOSIS, a non-interventional study in women presenting with clinical suspicion of pre-eclampsia. The main outcome measure from the economic model was the cost per patient per episode of care, from first suspicion of pre-eclampsia to birth.

Results: Introduction of the sFlt-1/PlGF ratio test into clinical practice is expected to result in cost savings of £344 per patient compared with a no-test scenario. Savings are generated primarily through an improvement in diagnostic accuracy and subsequent reduction in unnecessary hospitalization.

Conclusions: Introducing the sFlt-1/PlGF ratio test into clinical practice in the UK was shown to be cost-saving by reducing unnecessary hospitalization of women at low risk of developing pre-eclampsia. In addition, the test ensures that those women at higher risk are identified and managed appropriately. © 2016 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Keywords: cost-effectiveness; diagnosis; economic; hospitalization; model; pre-eclampsia; prediction; sFlt-1/PlGF.

MeSH terms

  • Biomarkers / metabolism
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Membrane Proteins / metabolism*
  • Models, Economic
  • Pre-Eclampsia / diagnosis*
  • Pre-Eclampsia / economics
  • Pre-Eclampsia / metabolism
  • Pregnancy
  • Prospective Studies
  • United Kingdom
  • Vascular Endothelial Growth Factor Receptor-1 / metabolism*

Substances

  • Biomarkers
  • Membrane Proteins
  • PIGF protein, human
  • FLT1 protein, human
  • Vascular Endothelial Growth Factor Receptor-1