Cost effectiveness
In the base case deterministic analysis, the FMF algorithm is associated
with an overall cost saving of £9.06 per pregnancy screened and a QALY
gain of 0.00006 when compared to standard care using the NICE screening
method. care. With a cohort of 5957 pregnant women, the use of the FMF
algorithm resulted in 7 fewer estimated cases of preterm PE (41) versus
48 pre-term PE cases with the NICE algorithm. Across a cohort of 5957
women the expected cost saving would be approximately £54,000. Overall,
the number of QALYs over a one-year time horizon was similar across the
two interventions, reflecting the fact that serious adverse events such
as stillbirth are relatively rare.
Figure 1 illustrates the distribution of incremental cost and QALY
outcomes from the probabilistic sensitivity analysis on a
cost-effectiveness plane with each dot representing a simulation of the
model accounting for parameter uncertainty. The values predominantly
fall within the north-western quadrant where FMF screening is associated
with greater cost-savings and health gains when compared to the NICE
method. The FMF screening method is cost saving in 67% of simulations
(Figure 1).