Roche Diagnostics International Ltd, Rotkreuz, Switzerland.
Roche Diagnostics Argentina, Buenos Aires, Argentina.
Value Health Reg Issues. 2023 Mar;34:1-8. doi: 10.1016/j.vhri.2022.09.003. Epub 2022 Nov 4.
Preeclampsia (PE) is a hypertensive disorder of pregnancy that can cause severe complications and adverse fetal/maternal outcomes. We aimed to estimate the annual economic impact of incorporating Elecsys® sFlt-1/PlGF PE ratio, which measures soluble fms-like tyrosine kinase-1 and placental growth factor, into routine clinical practice in Argentina to aid diagnosis of PE and hemolysis, elevated liver enzymes, and low platelets syndrome from second trimester onward in pregnancies with clinical suspicion of PE.
A decision tree was used to estimate annual economic impact on the Argentine health system as a whole, including relevant costs associated with diagnosis, follow-up, and treatment from initial presentation of clinically suspected PE to delivery. Annual costs of a standard-of-care scenario and a scenario including PE ratio (reference year 2021) were analyzed.
The economic model estimated that using the sFlt-1/PlGF ratio would enable the overall health system to save ∼$6987 million Argentine pesos annually (95% confidence interval $12 045-$2952 million), a 39.1% reduction in costs versus standard of care, mainly due to reduced hospitalizations of women with suspected PE. The economic impact calculation estimated net annual savings of approximately $80 504 Argentine pesos per patient with suspected PE. Based on the assumed uncertainty of the parameters, the likelihood the intervention would be cost saving was 100% for the considered scenarios.
Our analysis suggests that the implementation of the sFlt-1/PlGF ratio in women with suspected PE in Argentina will enable the health system to achieve significant savings, contributing to more efficient clinical management through the likely reduction of unnecessary hospitalizations, depending on assumptions. Results rest on the payers' ability to recover savings generated by the intervention.
子痫前期（PE）是一种妊娠高血压疾病，可导致严重并发症和母婴不良结局。我们旨在评估在阿根廷常规临床实践中纳入 Elecsys® sFlt-1/PlGF PE 比值（用于测量可溶性 fms 样酪氨酸激酶-1 和胎盘生长因子）的年度经济影响，以帮助诊断妊娠中期起有 PE 临床疑似症状的孕妇的 PE 和溶血、肝酶升高和血小板减少综合征。
采用决策树来评估阿根廷整个卫生系统的年度经济影响，包括与临床疑似 PE 初始表现至分娩相关的诊断、随访和治疗的相关成本。分析了标准护理方案和包括 PE 比值（参考年为 2021 年）的方案的年度成本。
经济模型估计，使用 sFlt-1/PlGF 比值将使整个卫生系统每年节省约 6.987 亿阿根廷比索（95%置信区间：1.2045 亿-2.952 亿），与标准护理相比，成本降低 39.1%，主要是由于疑似 PE 女性的住院人数减少。经济影响计算估计，每位疑似 PE 患者的年度净节省约为 80504 阿根廷比索。基于参数的假设不确定性，该干预措施极有可能实现成本节约，考虑到所考虑的方案，这种可能性为 100%。
我们的分析表明，在阿根廷，将 sFlt-1/PlGF 比值应用于疑似 PE 女性将使卫生系统实现显著节省，通过可能减少不必要的住院治疗，有助于更有效地进行临床管理，这取决于假设。结果取决于支付方收回干预措施产生的节省的能力。
