Costs and benefits of non‐invasive fetal RhD determination
| Autor: | L. Teitelbaum, R. D. Wilson, J. S. Parboosingh, Amy Metcalfe, Gwen Clarke, Jo-Ann Johnson |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Canada Pediatrics medicine.medical_specialty Fetal dna Cost-Benefit Analysis Rho(D) Immune Globulin Population Rh Isoimmunization Pregnancy Humans Medicine Radiology Nuclear Medicine and imaging education Fetus education.field_of_study Rh-Hr Blood-Group System Cell-Free System Radiological and Ultrasound Technology Cost–benefit analysis business.industry Pregnancy Complications Hematologic Non invasive Infant Newborn Obstetrics and Gynecology DNA General Medicine medicine.disease Reproductive Medicine Cell-free fetal DNA Female business Program Evaluation Decision analysis |
| Zdroj: | Ultrasound in Obstetrics & Gynecology. 45:84-88 |
| ISSN: | 1469-0705 0960-7692 |
| Popis: | Objective Non-invasive fetal Rhesus (Rh) D genotyping, using cell-free fetal DNA (cffDNA) in the maternal blood, allows targeted antenatal anti-RhD prophylaxis in unsensitized RhD-negative pregnant women. The purpose of this study was to determine the cost and benefit of this approach as compared to routine antenatal anti-RhD prophylaxis for all unsensitized RhD-negative pregnant women, as is the current policy in the province of Alberta, Canada. Methods This study was a decision analysis based on a theoretical population representing the total number of pregnancies in Alberta over a 1-year period (n = 69 286). A decision tree was created that outlined targeted prophylaxis for unsensitized RhD-negative pregnant women screened for cffDNA (targeted group) vs routine prophylaxis for all unsensitized RhD-negative pregnant women (routine group). Probabilities at each decision point and costs associated with each resource were calculated from local clinical and administrative data. Outcomes measured were cost, number of women sensitized and doses of Rh immunoglobulin (RhIG) administered. Results The estimated cost per pregnancy for the routine group was 71.43 compared with 67.20 Canadian dollars in the targeted group. The sensitization rates per RhD-negative pregnancy were equal, at 0.0012, for the current and targeted programs. Implementing targeted antenatal anti-RhD prophylaxis would save 4072 doses (20.1%) of RhIG over a 1-year period in Alberta when compared to the current program. Conclusions These data support the feasibility of a targeted antenatal anti-RhD prophylaxis program, at a lower cost than that of the existing routine prophylaxis program, with no increased risk of sensitization. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text