Elective cesarean delivery to prevent perinatal transmission of hepatitis C virus: A cost-effectiveness analysis - 25/08/11
Abstract |
Objective |
This study was undertaken to determine whether elective cesarean delivery to avert perinatal hepatitis C virus (HCV) transmission is cost-effective.
Study design |
Using decision analysis, we compared 2 approaches: (1) offering elective cesarean delivery to avert perinatal HCV transmission, (2) performing a cesarean delivery only for obstetric indications. Lifetime cost and quality-adjusted-life-years (QALYs) for HCV-infected neonates were evaluated with Markov analysis. We assumed elective cesarean delivery reduces perinatal HCV transmission, and we varied both the risk reduction caused by elective cesarean delivery and the background risk of perinatal HCV infection.
Results |
When elective cesarean section prevents all perinatal HCV transmission, 18 elective cesarean deliveries are necessary to avert 1 neonatal infection with a cost-effectiveness ratio of $34,812/QALY. At a background perinatal transmission rate of 7.7% elective cesarean deliveries is cost-effective only if it reduces the risk of perinatal transmission by more than 77%.
Conclusion |
Elective cesarean delivery is cost-effective only if it substantially reduces the risk of perinatal HCV transmission.
Le texte complet de cet article est disponible en PDF.Key words : Cost-effective, Hepatitis C, Perinatal transmission
Plan
| Supported by the Institute for Health Services Research and Policy Studies at Northwestern University and National Research Service Award 5 T32HS00078 from the Agency for Healthcare Research and Quality. Presented at the Twenty-Fourth Annual Meeting of the Society for Maternal Fetal Medicine, New Orleans, La, February 2-7, 2004. Reprints are not available from the authors. |
Vol 191 - N° 3
P. 998-1003 - septembre 2004 Retour au numéro
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