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Obstet Gynecol. 2006 Sep;108(3 Pt 1):492-9.

17alpha-hydroxyprogesterone caproate for the prevention of preterm delivery: A cost-effectiveness analysis.

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  • 1Department of Obstetrics and Gynecology, Center for Clinical Epidemiology and Biostatistics, Internal Medicine and Health Management Systems, Washington University Medical Center in St. Louis, Missouri 63110, USA. odiboa@wudosis.wustl.edu

Abstract

OBJECTIVE:

To evaluate whether the use of 17alpha-hydroxyprogesterone caproate for the prevention of recurrent preterm deliveries is cost-effective.

METHODS:

Using decision-analysis modeling, we compared the cost-effectiveness of using 17alpha-hydroxyprogesterone caproate in four subgroups: 1) Prior preterm deliveries less than 32 weeks; 2) prior preterm deliveries 32-37 weeks; 3) prior term delivery; and 4) no prior delivery. Each subgroup was compared with a "no treatment" group. Costs included those for 17alpha-hydroxyprogesterone caproate, hospital admissions, and complications from preterm deliveries. The main outcome measures include cost per quality-adjusted life-year gained and the number of preterm deliveries prevented. Secondary outcomes include neonatal complications prevented. One-way and multiway sensitivity analyses were performed.

RESULTS:

The use of 17alpha-hydroxyprogesterone caproate for the prevention of preterm deliveries result in cost-savings in women with prior preterm deliveries less than 32 weeks and 32-37 weeks. The sensitivity analyses revealed the model to be robust over a wide range of values for evaluated variables.

CONCLUSION:

Within our baseline assumptions, 17alpha-hydroxyprogesterone caproate was associated with cost-savings when used for the prevention of preterm deliveries in women with prior preterm deliveries.

[PubMed - indexed for MEDLINE]
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