Cost-Effectiveness of a Proteomic Test for Preterm Birth Prediction

作者：Michael Grabner, Julja Burchard, Chi Nguyen, Haechung Chung, Nilesh Gangan, J. Jay Boniface, John A. F. Zupancic, Eric J. Stanek · 发表于：ClinicoEconomics and Outcomes Research · 年份：2021 · DOI：10.2147/ceor.s325094 · 被引用次数：23 · 研究领域：Preterm Birth and Chorioamnionitis、Neonatal and fetal brain pathology、Pregnancy and preeclampsia studies

Background: Preterm birth (PTB) carries increased risk of short- and long-term health problems as well as higher healthcare costs. Current strategies using clinically accepted maternal risk factors (prior PTB, short cervix) can only identify a minority of singleton PTBs. Objective: We modeled the cost-effectiveness of a risk-screening-and-treat strategy versus usual care for commercially insured pregnant US women without clinically accepted PTB risk factors. The risk-screening-and-treat strategy included use of a novel PTB prognostic blood test (PreTRM ® ) in the 19th– 20th week of pregnancy, followed by treatment with a combined regimen of multi-component high-intensity-case-management and pharmacologic interventions for the remainder of the pregnancy for women assessed as higher-risk by the test, and usual care in women without higher risk. Methods: We built a cost-effectiveness model using a combined decision-tree/Markov approach and a US payer perspective. We modeled 1-week cycles of pregnancy from week 19 to birth (preterm or term) and assessed costs throughout the pregnancy, and further to 12-months post-delivery in mothers and 30-months in infants. PTB rates and costs were based on > 40,000 mothers and infants from the HealthCore Integrated Research Database ® with birth events in 2016. Estimates of test performance, treatment effectiveness, and other model inputs were derived from published literature. Results: In the base case, the risk-screening-and-treat strategy d...