Table 4.
Unit cost estimates and quality‐adjusted life year (QALY) weights of decision analytic model estimating cost‐effectiveness of strategies to prevent spontaneous preterm delivery in asymptomatic women with a singleton pregnancy, based on sonographic cervical length (CL) screening and vaginal progesterone treatment
| Variable | Point estimate (US dollars) | Range* | Reference |
|---|---|---|---|
| Costs | |||
| Vaginal progesterone (16‐week course), per treated woman | 130 | ± 20% | 38 |
| Education of midwife sonographers and implementation of a screening program if: | 39; see Methods | ||
| Universal screening or screening of low‐risk women at 18 + 0 to 20 + 6 weeks | 3 224 222 | ± 20% | |
| Screening of nulliparous women at 18 + 0 to 20 + 6 weeks | 1 617 111 | ± 20% | |
| Universal screening or screening of low‐risk women at 21 + 0 to 23 + 6 weeks | 2 259 956 | ± 20% | |
| Screening of high‐risk women at 21 + 0 to 23 + 6 weeks | 813 556 | ± 20% | |
| Screening of nulliparous women at 21 + 0 to 23 + 6 weeks | 1 134 978 | ± 20% | |
| Quality control of screening program | 52 732 | ± 20% | See Methods |
| TVS at 18 + 0 to 20 + 6 weeks, per scan | 58 | ± 20% | See Methods |
| TVS at 21 + 0 to 23 + 6 weeks, per scan | 117 | ± 20% | See Methods |
| Visit to physician for check‐ups, per visit | 175 | ± 20% | See Methods |
| Cost per delivery < 33 + 0 weeks | 6431 | ± 20% | See Methods |
| Cost per delivery at 33 + 0 to 36 + 6 weeks | 5222 | ± 20% | See Methods |
| Cost per delivery ≥ 37 + 0 weeks | 4289 | ± 20% | See Methods |
| Productivity loss (parental leave) per baby born < 33 + 0 weeks | 10 833 | ± 20% | 43 |
| Neonatal care per delivery < 33 + 0 weeks | 69 586 | ± 20% | See Methods |
| Neonatal care per delivery at 33 + 0 to 36 + 6 weeks | 11 739 | ± 20% | See Methods |
| Cost of extra stay at postpartum ward per baby born at 35 + 0 to 36 + 6 weeks not admitted to NICU | 2100 | ± 20% | See Methods |
| Neonatal care per delivery ≥ 37 + 0 weeks | 8146 | ± 20% | See Methods |
| Long‐term disability: | |||
| Annual healthcare cost per individual 0–19 years | 6415 | ± 20% | 44,45 |
| Annual healthcare cost per individual 20–54 years | 2135 | ± 20% | 44,45 |
| Annual healthcare cost per individual > 54 years | 976 | ± 20% | 44,45 |
| Annual social cost per individual (pre‐school 1–6 years) | 76 511 | ± 20% | 44,45 |
| Annual social cost per individual (school 7–16 years) | 39 762 | ± 20% | 44,45 |
| Annual social cost for day‐care center per individual 0–18 years | 11 297 | ± 20% | 44,45 |
| Annual social cost for institutional residence per individual 0–18 years | 135 566 | ± 20% | 44,45 |
| Annual social cost for sheltered workshop per individual > 18 years | 16 796 | ± 20% | 44,45 |
| Annual social cost for day‐care center per individual > 18 years | 30 310 | ± 20% | 44,45 |
| Annual social cost for institutional residence per individual > 18 years | 119 929 | ± 20% | 44,45 |
| Annual social cost for temporary institutional residence per individual > 18 years | 9994 | ± 20% | 44,45 |
| Daily cost for absence from work per individual | 217 | ± 20% | 44,45 |
| QALY weights | |||
| Neonatal death | 0.00 | 46–48 | |
| Long‐term morbidity | 0.55 | 0.06 | 46–48 |
| Healthy neonate | 1.00 | 46–48 |
*
Range means values used in sensitivity analyses and is presented as standard error (SE) or as ± 20%.
NICU, neonatal intensive care unit; TVS, transvaginal sonography.