Economic evaluation of the sFlt-1/PlGF ratio for the short-term prediction of preeclampsia in a Japanese cohort of the PROGNOSIS Asia study

Hypertens Res. 2021 Jul;44(7):822-829. doi: 10.1038/s41440-021-00624-2. Epub 2021 Feb 16.


The PRediction of short-term Outcomes in preGNant wOmen with Suspected preeclampsIa Study (PROGNOSIS) Asia validated the use of the soluble fms-like tyrosine 1/placental growth factor (sFlt-1/PlGF) ratio cutoff value of ≤38 to rule out the occurrence of preeclampsia in the short term in Asian women. We assessed the economic impact of the introduction of the sFlt-1/PlGF ratio test for predicting preeclampsia in Japan using data from the Japanese cohort of PROGNOSIS Asia. The cost analysis was developed with estimates in either a no-test scenario, with clinical decisions based on standard diagnostic procedures alone, or a test scenario, in which the sFlt-1/PlGF ratio test was used in addition to standard diagnostic procedures. For both scenarios, rates of hospitalization and other test characteristics were obtained from the results for the Japanese cohort in PROGNOSIS Asia. The total cost per patient was the main outcome of this cost analysis model. Introduction of the sFlt-1/PlGF ratio test using a cutoff value of 38 resulted in a reduced hospitalization rate compared with the rate in the no-test scenario (14.4% versus 8.7%). The reduction in the rate of hospitalizations led to an estimated 16 373 JPY reduction in healthcare costs per patient. The sFlt-1/PlGF ratio test is likely to reduce the unnecessary hospitalization of women at low risk of developing preeclampsia in the short term while also identifying high-risk individuals requiring appropriate management. Reducing unnecessary hospitalizations would result in significant cost savings in the Japanese healthcare system.

Keywords: Cost saving; Japan; Prediction; Preeclampsia; sFlt-1/PlGF ratio.

MeSH terms

  • Biomarkers / blood
  • Cohort Studies
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Japan
  • Placenta Growth Factor / blood
  • Pre-Eclampsia* / blood
  • Pre-Eclampsia* / diagnosis
  • Pregnancy
  • Prenatal Diagnosis* / economics
  • Vascular Endothelial Growth Factor Receptor-1 / blood


  • Biomarkers
  • Placenta Growth Factor
  • Vascular Endothelial Growth Factor Receptor-1