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Magnesium sulphate for fetal neuroprotection: a cost-effectiveness analysis Bickford, Celeste D.; Magee, Laura A.; Mitton, Craig, 1972-; Kruse, Marie; Synnes, Anne; Sawchuck, Diane; Basso, Melanie; Senikas, Vyta M.; von Dadelszen, Peter

Abstract

Background: The aim of this study was to assess the cost-effectiveness of administering magnesium sulphate to patients in whom preterm birth at < 32+0 weeks gestation is either imminent or threatened for the purpose of fetal neuroprotection. Methods Multiple decision tree models and probabilistic sensitivity analyses were used to compare the administration of magnesium sulphate with the alternative of no treatment. Two separate cost perspectives were utilized in this series of analyses: a health system and a societal perspective. In addition, two separate measures of effectiveness were utilized: cases of cerebral palsy (CP) averted and quality-adjusted life years (QALYs). Results From a health system and a societal perspective, respectively, a savings of $2,242 and $112,602 is obtained for each QALY gained and a savings of $30,942 and $1,554,198 is obtained for each case of CP averted when magnesium sulphate is administered to patients in whom preterm birth is imminent. From a health system perspective and a societal perspective, respectively, a cost of $2,083 is incurred and a savings of $108,277 is obtained for each QALY gained and a cost of $28,755 is incurred and a savings of $1,494,500 is obtained for each case of CP averted when magnesium sulphate is administered to patients in whom preterm birth is threatened. Conclusions Administration of magnesium sulphate to patients in whom preterm birth is imminent is a dominant (i.e. cost-effective) strategy, no matter what cost perspective or measure of effectiveness is used. Administration of magnesium sulphate to patients in whom preterm birth is threatened is a dominant strategy from a societal perspective and is very likely to be cost-effective from a health system perspective.

Item Metadata

Title
Magnesium sulphate for fetal neuroprotection: a cost-effectiveness analysis
Creator
Bickford, Celeste D.; Magee, Laura A.; Mitton, Craig, 1972-; Kruse, Marie; Synnes, Anne; Sawchuck, Diane; Basso, Melanie; Senikas, Vyta M.; von Dadelszen, Peter
Publisher
BioMed Central
Date Issued
2013-12-19
Description
Background: The aim of this study was to assess the cost-effectiveness of administering magnesium sulphate to patients in whom preterm birth at < 32+0 weeks gestation is either imminent or threatened for the purpose of fetal neuroprotection. Methods Multiple decision tree models and probabilistic sensitivity analyses were used to compare the administration of magnesium sulphate with the alternative of no treatment. Two separate cost perspectives were utilized in this series of analyses: a health system and a societal perspective. In addition, two separate measures of effectiveness were utilized: cases of cerebral palsy (CP) averted and quality-adjusted life years (QALYs). Results From a health system and a societal perspective, respectively, a savings of $2,242 and $112,602 is obtained for each QALY gained and a savings of $30,942 and $1,554,198 is obtained for each case of CP averted when magnesium sulphate is administered to patients in whom preterm birth is imminent. From a health system perspective and a societal perspective, respectively, a cost of $2,083 is incurred and a savings of $108,277 is obtained for each QALY gained and a cost of $28,755 is incurred and a savings of $1,494,500 is obtained for each case of CP averted when magnesium sulphate is administered to patients in whom preterm birth is threatened. Conclusions Administration of magnesium sulphate to patients in whom preterm birth is imminent is a dominant (i.e. cost-effective) strategy, no matter what cost perspective or measure of effectiveness is used. Administration of magnesium sulphate to patients in whom preterm birth is threatened is a dominant strategy from a societal perspective and is very likely to be cost-effective from a health system perspective.
Subject
Magnesium sulphate; Fetal neuroprotection; Preterm birth; Cerebral palsy; Cost-effectiveness
Genre
Article
Type
Text
Language
eng
Date Available
2015-12-18
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0221432
URI
http://hdl.handle.net/2429/55928
Affiliation
Medicine, Department of; Obstetrics and Gynaecology, Department of; Population and Public Health (SPPH), School of; Other UBC; Non UBC; Medicine, Faculty of
Citation
BMC Health Services Research. 2013 Dec 19;13(1):527
Publisher DOI
10.1186/1472-6963-13-527
Peer Review Status
Reviewed
Scholarly Level
Faculty
Copyright Holder
Bickford et al.; licensee BioMed Central Ltd.
Rights URI
http://creativecommons.org/licenses/by/4.0/
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Attribution 4.0 International (CC BY 4.0)