The sflt-1/plgf ratio test in pre-eclampsia: an economic assessment for the UK.
Vatish M., Strunz-McKendry T., Hund M., Allegranza D., Wolf C., Smare C.
OBJECTIVES: To assess the economic impact of introducing the soluble FMS-like tyrosine kinase (sFlt-1) to placental growth factor (PlGF) ratio test into clinical practice in the United Kingdom (UK). METHODS: Economic model estimating the incremental value of the information from a UK National Health Service (NHS) payer perspective generated by the sFlt-1/PlGF ratio test, compared with current diagnostic procedures, in guiding the management of women with suspected pre-eclampsia. The economic model estimated costs associated with the diagnosis and management of pre-eclampsia in women between 24 weeks and 36 weeks + 6 days of gestation managed in either a 'test' scenario in which the sFlt-1/PlGF test is used in addition to current diagnostic procedures, or a 'no-test' scenario in which clinical decisions are based on current diagnostic procedures alone. Test characteristics and resource use were derived from PROGNOSIS, a non-interventional study in women presenting with clinical suspicion of pre-eclampsia. The main outcome measure from the economic model was the cost per patient per episode of care (from first suspicion of pre-eclampsia to birth). RESULTS: Introduction of the sFlt-1/PlGF ratio test is expected to result in cost savings of £344 per patient compared with a 'no-test' scenario. Savings are generated primarily through an improvement in diagnostic accuracy and a reduction in unnecessary hospitalisation. CONCLUSIONS: The sFlt-1/PlGF ratio test has the potential to improve clinical decision-making, reducing unnecessary hospitalisation of women at low risk of developing pre-eclampsia, and ensuring that those women at higher risk are identified and managed appropriately.