Placental growth factor testing for suspected pre-eclampsia: a cost-effectiveness analysis

Abstract

Objective: To calculate the cost-effectiveness of implementing PlGF testing alongside a clinical management algorithm in maternity services in the UK, compared with current standard care. Design: Cost-effectiveness analysis. Setting: Eleven maternity units participating in the PARROT stepped-wedge cluster-randomised controlled trial. Population: Women presenting with suspected pre-eclampsia between 20+0 and 36+6 weeks’ gestation. Methods: Monte Carlo simulation utilising resource use data and maternal adverse outcomes. Main outcome measures: Cost per maternal adverse outcome prevented. Results: Clinical care with PlGF testing costs less than current standard practice and resulted in fewer maternal adverse outcomes. There is a total cost-saving of UK£149 per patient tested, when including the cost of the test. This represents a potential cost-saving of UK£2,891,196 each year across the NHS in England. Conclusions: Clinical care with PlGF testing is associated with the potential for cost-savings per participant tested when compared with current practice via a reduction in outpatient attendances, and improves maternal outcomes. This economic analysis supports a role for implementation of PlGF testing in antenatal services for the assessment of women with suspected pre-eclampsia. Tweetable abstract: Placental growth factor testing for suspected pre-eclampsia is cost-saving and improves maternal outcomes.