Cost-effectiveness analysis of first trimester screening for preeclampsia and early initiation of aspirin therapy for prevention of the disease in a private tertiary hospital

Abstract

Background: Preeclampsia (PE) has significant health and economic burden. Early screening for PE through first trimester screening (FTS) can direct decision-making on early initiation of aspirin (ASA) therapy, which has been known to reduce the incidence of PE. Objectives: The objective of the study is to evaluate the cost-effectiveness of FTS and early initiation of ASA for disease prevention. Methodology: A population of 1916 women who delivered in a private tertiary hospital from January 2019 to March 2020 was categorized based on the risk of developing PE, results of FTS, initiation of ASA therapy, development of PE, and mode of delivery. Descriptive statistics using counts and percentages were used to summarize the data. Association between ASA therapy and PE was assessed using the Chi-square test. Costs of screening, ASA therapy, inpatient management, and delivery were computed. Results and Conclusion: Results showed that PE was prevented in 71.4% of those high-risk patients who underwent FTS and started on ASA therapy. Total cost of urgent care of PE and delivery was P119,687.02 to P149,687.02 for early PE, and P103,587.02 to P133,587.02 for late PE. Prevention of early PE and late PE results in net cost savings of P69,694.02 and P53,594.02, respectively, with the investment of P9,993.00 on FTS and ASA therapy. Implementation of FTS and initiation ASA therapy is an effective and cost-saving approach that can prevent PE.