title: Economic assessment of screening for pre-eclampsia.
abstract: 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.
authors.affiliation: Department of Health Management and Economics, Braun School of Public Health, The Hebrew University-Hadassah, Israel..
authors.forename: Amir
authors.initials: A
authors.lastname: Shmueli
authors.forename: Hamutal
authors.initials: H
authors.lastname: Meiri
authors.forename: Ron
authors.initials: R
authors.lastname: Gonen
mesh_terms: D000328:Adult; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D003955:Diagnostic Tests, Routine / Q000191:economics* / Q000379:methods; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008962:Models, Theoretical; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000191:economics* / Q000517:prevention & control; D011247:Pregnancy; D011322:Primary Prevention / Q000191:economics / Q000379:methods*