[Public health economic evaluation of screening for APC resistance (Leiden mutation) in new oral contraceptive users].
BACKGROUND
Thromboembolic events in users of oral contraceptives rank among the most important complications with potential economic consequences. It is well known that a large part of thromboembolic complications correlates with hereditary thrombophilias. The relative high prevalence of the newly described resistance of activated protein C and an easy test for it rise up the question if general screening of new users of oral contraceptives is sensible of health economic view.


METHODS
We conducted a cost-effectiveness analysis using decision analytic techniques, analysing the costs and outcomes in a hypothetical cohort of 10,000 women.


CONCLUSIONS
From a third party payer perspective we estimate that screening for APC resistance by new users of oral contraceptives is more cost-effective than many other primary preventive methods. The cost per life-year gained of testing for APC resistance were in the order of DM 1544,--including direct medical cost only. From perspective of sickness insurance fund as cost unit we estimate that screening for APC resistance by new users of oral contraceptives is more cost-effective than many other primary preventive methods.
Szucs
T
T
Hämostaseologische Abteilung/Klinische Okonomie Ludwig-Maximilans-Universität München.
Osterkorn
D
D
Schramm
W
W
D000293:Adolescent; D000328:Adult; D003276:Contraceptives, Oral / Q000009:adverse effects*; D003362:Cost-Benefit Analysis; D005260:Female; D005858:Germany; D006801:Humans; D008403:Mass Screening / Q000191:economics; D008875:Middle Aged; D009154:Mutation; D009842:Oligopeptides / Q000235:genetics*; D011486:Protein C / Q000235:genetics*; D012307:Risk Factors; D013923:Thromboembolism / Q000139:chemically induced / Q000191:economics / Q000235:genetics / Q000517:prevention & control*
D003276:Contraceptives, Oral; D009842:Oligopeptides; D011486:Protein C; C047135:protein C activator peptide
Gesundheitsökonomische Evaluation des Screenings auf APC-Resistenz (Mutation Leiden) bei Neuanwenderinnen von Ovulationshemmern