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

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.

• Authors: Celeste D Bickford, Laura A Magee, Craig Mitton, Marie Kruse, Anne R Synnes, Diane Sawchuck, Melanie Basso, Vyta M Senikas, Peter von Dadelszen, MAG-CP Working Group
• Journal: BMC health services research (BMC Health Serv Res) Vol. 13 Pg. 527 (Dec 19 2013) ISSN: 1472-6963 [Electronic] England
• PMID: 24350635 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Neuroprotective Agents
• Magnesium Sulfate

Topics

• Cerebral Palsy (economics, prevention & control)
• Cost Savings (statistics & numerical data)
• Cost-Benefit Analysis
• Decision Trees
• Drug Costs (statistics & numerical data)
• Female
• Fetus (drug effects)
• Gestational Age
• Health Care Costs (statistics & numerical data)
• Humans
• Magnesium Sulfate (economics, therapeutic use)
• Neuroprotective Agents (economics, therapeutic use)
• Pregnancy
• Premature Birth (drug therapy, epidemiology)
• Prenatal Care (economics)
• Quality of Life
• Quality-Adjusted Life Years
• Risk Assessment