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用一种新型检测方法补充当前子痫前期的诊断实践是否能节省费用?从德国医保支付方角度进行建模分析得出的经验教训。

Are there financial savings associated with supplementing current diagnostic practice for preeclampsia with a novel test? Learnings from a modeling analysis from a German payer perspective.

作者信息

Hadker Nandini, Garg Suchita, Costanzo Cory, van der Helm Wim, Creeden James

机构信息

United BioSource Corporation, Lexington, MA 02420, USA.

出版信息

Hypertens Pregnancy. 2013 May;32(2):105-19. doi: 10.3109/10641955.2011.638958.

Abstract

OBJECTIVE

To quantify the financial impact of adding a novel serum test to the current diagnostic toolkit for preeclampsia (PE) detection in Germany.

METHODS

A decision-analytic model was created to quantify the economic impact of adding a recently developed novel diagnostic test for PE (Roche Diagnostics, Rotkreuz, Switzerland) to current diagnostic practice in Germany. The model simulated a cohort of 1000 pregnant patients receiving obstetric care and quantified the budget impact of adding the novel test to current German PE detection and management practices.

RESULTS

The model estimates that the costs associated with managing a typical pregnancy in Germany are €941 when the novel test is used versus €1579 with standard practice. This represents savings of €637 per pregnant woman, even when the test is used as a supplementary diagnostic tool. The savings are attributed to the novel test's ability to better classify patients relative to current practice, specifically, its ability to reduce false negatives by 67% and false positives by 71%.

CONCLUSION

The novel PE test has the potential to provide substantial cost savings to German healthcare payers, even when used as an addition to standard practice. Better classification of patients at risk for developing PE and declassification of those that are not compared to current practice leads to economic savings for the healthcare system. Furthermore, by reducing the rates of false-positive and false-negative classification relative to current standard of care, the test helps better target healthcare spending and lowers overall costs associated with PE care.

摘要

目的

量化在德国用于子痫前期(PE)检测的现有诊断工具包中添加一种新型血清检测的财务影响。

方法

创建了一个决策分析模型,以量化在德国当前的诊断实践中添加一种最近开发的用于PE的新型诊断测试(罗氏诊断公司,瑞士罗特kreuz)的经济影响。该模型模拟了1000名接受产科护理的孕妇队列,并量化了在德国当前的PE检测和管理实践中添加该新型测试的预算影响。

结果

该模型估计,使用新型测试时,德国管理典型妊娠的成本为941欧元,而标准做法为1579欧元。即使将该测试用作辅助诊断工具,每位孕妇也可节省637欧元。节省的原因在于,相对于当前做法,新型测试能够更好地对患者进行分类,具体而言,它能够将假阴性降低67%,将假阳性降低71%。

结论

即使作为标准做法的补充,新型PE测试也有可能为德国医疗保健支付方节省大量成本。与当前做法相比,对有发展为PE风险的患者进行更好的分类以及对无风险患者进行排除,可为医疗保健系统带来经济节省。此外,相对于当前的护理标准,通过降低假阳性和假阴性分类率,该测试有助于更精准地确定医疗保健支出目标,并降低与PE护理相关的总体成本。

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