title: Magnesium sulphate for fetal neuroprotection: a cost-effectiveness analysis.
abstract: BACKGROUND
  The aim of this study was to assess the cost-effectiveness of administering magnesium sulphate to patients in whom preterm birth at < 32+0 weeks gestation is either imminent or threatened for the purpose of fetal neuroprotection.
  
  
  METHODS
  Multiple decision tree models and probabilistic sensitivity analyses were used to compare the administration of magnesium sulphate with the alternative of no treatment. Two separate cost perspectives were utilized in this series of analyses: a health system and a societal perspective. In addition, two separate measures of effectiveness were utilized: cases of cerebral palsy (CP) averted and quality-adjusted life years (QALYs).
  
  
  RESULTS
  From a health system and a societal perspective, respectively, a savings of $2,242 and $112,602 is obtained for each QALY gained and a savings of $30,942 and $1,554,198 is obtained for each case of CP averted when magnesium sulphate is administered to patients in whom preterm birth is imminent. From a health system perspective and a societal perspective, respectively, a cost of $2,083 is incurred and a savings of $108,277 is obtained for each QALY gained and a cost of $28,755 is incurred and a savings of $1,494,500 is obtained for each case of CP averted when magnesium sulphate is administered to patients in whom preterm birth is threatened.
  
  
  CONCLUSIONS
  Administration of magnesium sulphate to patients in whom preterm birth is imminent is a dominant (i.e. cost-effective) strategy, no matter what cost perspective or measure of effectiveness is used. Administration of magnesium sulphate to patients in whom preterm birth is threatened is a dominant strategy from a societal perspective and is very likely to be cost-effective from a health system perspective.
authors.affiliation: School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada. celesteb@interchange.ubc.ca.
authors.forename: Celeste D
authors.initials: CD
authors.lastname: Bickford
authors.forename: Laura A
authors.initials: LA
authors.lastname: Magee
authors.forename: Craig
authors.initials: C
authors.lastname: Mitton
authors.forename: Marie
authors.initials: M
authors.lastname: Kruse
authors.forename: Anne R
authors.initials: AR
authors.lastname: Synnes
authors.forename: Diane
authors.initials: D
authors.lastname: Sawchuck
authors.forename: Melanie
authors.initials: M
authors.lastname: Basso
authors.forename: Vyta M
authors.initials: VM
authors.lastname: Senikas
authors.forename: Peter
authors.initials: P
authors.lastname: von Dadelszen
mesh_terms: D002547:Cerebral Palsy / Q000191:economics / Q000517:prevention & control; D017046:Cost Savings / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D005333:Fetus / Q000187:drug effects; D005865:Gestational Age; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008278:Magnesium Sulfate / Q000191:economics* / Q000627:therapeutic use; D018696:Neuroprotective Agents / Q000191:economics* / Q000627:therapeutic use; D011247:Pregnancy; D047928:Premature Birth / Q000188:drug therapy* / Q000453:epidemiology; D011295:Prenatal Care / Q000191:economics; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D018570:Risk Assessment
chemical_list: D018696:Neuroprotective Agents; D008278:Magnesium Sulfate