Cost-effectiveness of the sFlt-1/PlGF ratio test in pregnant patients
with suspected Pre-eclampsia: A Systematic Review
Abstract
Background: Pre-eclampsia (PE) affects approximately 2-4% of
pregnancies. Diagnosis involves repeated assessment of pregnant patients
with risk factors. The sFlt-1/PlGF ratio test is shown to have clinical
utility in ruling in and out PE among at-risk patients. By excluding the
probability of PE, the addition of the sFlt-1/PlGF ratio test to
antenatal care, may prevent unnecessary hospital admissions, intensive
management, and premature delivery, thus reducing costs.
Objectives: A systematic review to determine the
cost-effectiveness of the sFlt-1/PlGF ratio test globally for pregnant
patients at-risk of developing PE. Search Strategy: PubMed,
Medline (OVID), National Health Service Economic Evaluation Database,
Web of Science, Econlit, and Cost Effectiveness Analysis Registry
searched between 2013-April 2023. Selection Criteria: Empirical
studies quantifying costs of the sFlt-1/PlGF ratio test compared to
other treatment options for patients with suspected PE. Data
collection and Analysis: Eleven studies were included; all were cost
analyses and modelled economic evaluations, and most used a health
system perspective. Cost data were extracted and indexed to 2022 United
States Dollars (USD). Main results: All studies reported
“cost-savings” of the test in antenatal care. Studies varied with
costs and assumptions included, therefore a large range of incremental
cost savings per patient was reported ($15-$1,881, 2022USD). No
Incremental Cost-Effectiveness Ratios or health outcomes including
Quality Adjusted Life Years were reported. Conclusions: The
included studies demonstrated “cost-savings” of the sFlt-1/PlGF ratio
test in antenatal care for at-risk pregnant patients. However, this does
not account for health outcome differences and long-term health care
utilisation and expenditure. Funding: Nil