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Magnesium sulphate for fetal neuroprotection: a cost-effectiveness analysis.

Bickford, CD; Magee, LA; Mitton, C; Kruse, M; Synnes, AR; Sawchuck, D; Basso, M; Senikas, VM; von Dadelszen, P; MAG-CP Working Group, MAG-CP (2013) Magnesium sulphate for fetal neuroprotection: a cost-effectiveness analysis. BMC Health Services Research, 13. p. 527. https://doi.org/10.1186/1472-6963-13-527
SGUL Authors: von Dadelszen, Peter

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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 Type: Article
Additional Information: © 2013 Bickford et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Cerebral Palsy, Cost Savings, Cost-Benefit Analysis, Decision Trees, Drug Costs, Female, Fetus, Gestational Age, Health Care Costs, Humans, Magnesium Sulfate, Neuroprotective Agents, Pregnancy, Premature Birth, Prenatal Care, Quality of Life, Quality-Adjusted Life Years, Risk Assessment, MAG-CP Working Group, Fetus, Humans, Cerebral Palsy, Premature Birth, Magnesium Sulfate, Neuroprotective Agents, Prenatal Care, Risk Assessment, Gestational Age, Pregnancy, Decision Trees, Quality-Adjusted Life Years, Quality of Life, Cost-Benefit Analysis, Cost Savings, Health Care Costs, Drug Costs, Female, Health Policy & Services, 1117 Public Health And Health Services, 0807 Library And Information Studies
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: BMC Health Services Research
Language: eng
Dates:
DateEvent
19 December 2013Published
Publisher License: Creative Commons: Attribution 3.0
Projects:
Project IDFunderFunder ID
MAG-CPCanadian Institutes of Health Researchhttp://dx.doi.org/10.13039/501100000024
PubMed ID: 24350635
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107501
Publisher's version: https://doi.org/10.1186/1472-6963-13-527

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