title: Budget impact analysis of sFlt-1/PlGF ratio as prediction test in Italian women with suspected preeclampsia.
abstract: BACKGROUND
  Preeclampsia (PE) is a pregnancy disease which represents a leading cause of maternal and perinatal mortality and morbidity. Accurate prediction of PE risk could provide an increase in health benefits and better patient management.
  
  
  OBJECTIVE
  To estimate the economic impact of introducing Elecsys sFlt-1/PlGF ratio test, in addition to standard practice, for the prediction of PE in women with suspected PE in the Italian National Health Service (INHS).
  
  
  METHODS
  A decision tree model has been developed to simulate the progression of a cohort of pregnant women from the first presentation of clinical suspicion of PE in the second and third trimesters until delivery. The model provides an estimation of the financial impact of introducing sFlt-1/PlGF versus standard practice. Clinical inputs have been derived from PROGNOSIS study and from literature review, and validated by National Clinical Experts. Resources and unit costs have been obtained from Italian-specific sources.
  
  
  RESULTS
  Healthcare costs associated with the management of a pregnant woman with clinical suspicion of PE equal €2384 when following standard practice versus €1714 using sFlt-1/PlGF ratio test.
  
  
  CONCLUSIONS
  Introduction of sFlt-1/PlGF into hospital practice is cost-saving. Savings are generated primarily through improvement in diagnostic accuracy and reduction in unnecessary hospitalization for women before PE's onset.
authors.affiliation: a Department of Obstetrics and Gynecology , University of Parma , Parma , Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Frusca
authors.affiliation: b Azienda Ospedaliera di Padova , Padova , Italy.
authors.forename: Maria-Teresa
authors.initials: MT
authors.lastname: Gervasi
authors.affiliation: c Roche Diagnostics , Monza , Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Paolini
authors.affiliation: c Roche Diagnostics , Monza , Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Dionisi
authors.affiliation: d Scuola Superiore Sant'Anna, Istituto di Management - Laboratorio Management e Sanità , Pisa , Italy.|e Temas srl , Milan , Italy , and.
authors.forename: Francesca
authors.initials: F
authors.lastname: Ferre
authors.affiliation: f Department of Biomedical and Clinical Sciences "Luigi Sacco" , University of Milan , Milan , Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Cetin
mesh_terms: D015415:Biomarkers / Q000097:blood; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000191:economics* / Q000379:methods; D007558:Italy; D000072483:Placenta Growth Factor / Q000097:blood*; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000378:metabolism; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000097:blood; D011263:Pregnancy Trimester, Third / Q000097:blood; D012307:Risk Factors; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*
chemical_list: D015415:Biomarkers; D000072483:Placenta Growth Factor; D040281:Vascular Endothelial Growth Factor Receptor-1
keywords: PlGF; Preeclampsia; budget impact; sFlt; sFlt-1