Tags

Type your tag names separated by a space and hit enter

Economic evaluation of a neural tube defect recurrence-prevention program.
Am J Prev Med. 2008 Dec; 35(6):572-7.AJ

Abstract

BACKGROUND

Women with a pregnancy affected by a neural tube defect (NTD) are encouraged to take folic acid prior to a subsequent pregnancy, but it is unknown whether organized attempts to identify and counsel such women to prevent recurrent NTDs are cost effective.

METHODS

Data from the South Carolina recurrence-prevention program for October 2001-September 2002 were analyzed between October 2002 and December 2003 to calculate costs. Cost-effectiveness modeling of the program during 1992-2006 was conducted during 2007. Results were calculated for three scenarios based on recurrence risk, supplement use, and the effectiveness of folic acid in preventing recurrences. For each scenario, quality-adjusted life years (QALYs) were calculated separately using prevented NTD-affected live births; prevented NTD-affected births (including fetal deaths); and all prevented NTD-affected pregnancies.

RESULTS

The prevention program cost approximately $155,000 per year in 2003 dollars to protect 35 pregnancies and prevent approximately one NTD. The direct costs associated with an NTD depend on type and outcome, but are approximately $560,000 in 2003 dollars for a live birth with spina bifida. The base-case cost-effectiveness ratio was $39,600 per QALY gained from avoided NTD-affected live births and stillbirths, and $14,700 per QALY gained from the avoidance of all NTD-affected pregnancies. The baseline NTD recurrence risk and the use of folic acid supplements by women who are at high risk for an NTD-affected pregnancy were influential parameters.

CONCLUSIONS

The South Carolina NTD recurrence-prevention program appears comparable in cost effectiveness to other preventive services. Other states might consider including NTD recurrence prevention in birth defect-prevention programs.

Authors+Show Affiliations

National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia 30333, USA. sgrosse@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

18845415

Citation

Grosse, Scott D., et al. "Economic Evaluation of a Neural Tube Defect Recurrence-prevention Program." American Journal of Preventive Medicine, vol. 35, no. 6, 2008, pp. 572-7.
Grosse SD, Ouyang L, Collins JS, et al. Economic evaluation of a neural tube defect recurrence-prevention program. Am J Prev Med. 2008;35(6):572-7.
Grosse, S. D., Ouyang, L., Collins, J. S., Green, D., Dean, J. H., & Stevenson, R. E. (2008). Economic evaluation of a neural tube defect recurrence-prevention program. American Journal of Preventive Medicine, 35(6), 572-7. https://doi.org/10.1016/j.amepre.2008.07.008
Grosse SD, et al. Economic Evaluation of a Neural Tube Defect Recurrence-prevention Program. Am J Prev Med. 2008;35(6):572-7. PubMed PMID: 18845415.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Economic evaluation of a neural tube defect recurrence-prevention program. AU - Grosse,Scott D, AU - Ouyang,Lijing, AU - Collins,Julianne S, AU - Green,Denise, AU - Dean,Jane H, AU - Stevenson,Roger E, Y1 - 2008/10/08/ PY - 2008/02/08/received PY - 2008/05/14/revised PY - 2008/07/31/accepted PY - 2008/10/11/pubmed PY - 2009/1/1/medline PY - 2008/10/11/entrez SP - 572 EP - 7 JF - American journal of preventive medicine JO - Am J Prev Med VL - 35 IS - 6 N2 - BACKGROUND: Women with a pregnancy affected by a neural tube defect (NTD) are encouraged to take folic acid prior to a subsequent pregnancy, but it is unknown whether organized attempts to identify and counsel such women to prevent recurrent NTDs are cost effective. METHODS: Data from the South Carolina recurrence-prevention program for October 2001-September 2002 were analyzed between October 2002 and December 2003 to calculate costs. Cost-effectiveness modeling of the program during 1992-2006 was conducted during 2007. Results were calculated for three scenarios based on recurrence risk, supplement use, and the effectiveness of folic acid in preventing recurrences. For each scenario, quality-adjusted life years (QALYs) were calculated separately using prevented NTD-affected live births; prevented NTD-affected births (including fetal deaths); and all prevented NTD-affected pregnancies. RESULTS: The prevention program cost approximately $155,000 per year in 2003 dollars to protect 35 pregnancies and prevent approximately one NTD. The direct costs associated with an NTD depend on type and outcome, but are approximately $560,000 in 2003 dollars for a live birth with spina bifida. The base-case cost-effectiveness ratio was $39,600 per QALY gained from avoided NTD-affected live births and stillbirths, and $14,700 per QALY gained from the avoidance of all NTD-affected pregnancies. The baseline NTD recurrence risk and the use of folic acid supplements by women who are at high risk for an NTD-affected pregnancy were influential parameters. CONCLUSIONS: The South Carolina NTD recurrence-prevention program appears comparable in cost effectiveness to other preventive services. Other states might consider including NTD recurrence prevention in birth defect-prevention programs. SN - 1873-2607 UR - https://www.unboundmedicine.com/medline/citation/18845415/Economic_evaluation_of_a_neural_tube_defect_recurrence_prevention_program_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-3797(08)00736-8 DB - PRIME DP - Unbound Medicine ER -