| Autor: |
S M S, Liem, G J, van Baaren, F M C, Delemarre, I M, Evers, G, Kleiverda, A J, van Loon, J, Langenveld, N, Schuitemaker, J M, Sikkema, B C, Opmeer, M G, van Pampus, B W J, Mol, D J, Bekedam |
| Rok vydání: |
2014 |
| Předmět: |
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| Zdroj: |
Ultrasound in obstetricsgynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 44(3) |
| ISSN: |
1469-0705 |
| Popis: |
To assess the cost-effectiveness of a cervical pessary to prevent preterm delivery in women with a multiple pregnancy.The study design comprised an economic analysis of data from a randomized clinical trial evaluating cervical pessaries (ProTWIN). Women with a multiple pregnancy were included and an economic evaluation was performed from a societal perspective. Costs were estimated between the time of randomization and 6 weeks postpartum. The prespecified subgroup of women with a cervical length (CL)25(th) centile (38 mm) was analyzed separately. The primary endpoint was poor perinatal outcome occurring up to 6 weeks postpartum. Direct medical costs and health outcomes were estimated and incremental cost-effectiveness ratios for costs to prevent one poor outcome were calculated.Mean costs in the pessary group (n = 401) were € 21,783 vs € 21,877 in the group in which no pessary was used (n = 407) (difference, -€ 94; 95% CI, -€ 5975 to € 5609). In the prespecified subgroup of women with a CL38 mm we demonstrated a significant reduction in poor perinatal outcome (12% vs 29%; RR, 0.40; 95% CI, 0.19-0.83). Mean costs in the pessary group (n = 78) were € 25,141 vs € 30,577 in the no-pessary group (n = 55) (difference, -€ 5436 (95% CI, -€ 11,001 to € 1456). In women with a CL38 mm, pessary treatment was the dominant strategy (more effective and less costly) with a probability of 94%.Cervical pessaries in women with a multiple pregnancy involve costs comparable to those in women without pessary treatment. However, in women with a CL38 mm, treatment with a cervical pessary appears to be highly cost-effective. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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