Peer-Reviewed Journal Details
Mandatory Fields
Murphy, A,McCarthy, FP,McElroy, B,Khashan, AS,Spillane, N,Marchocki, Z,Sarkar, RK,Higgins, JR
European Journal of Obstetrics & Gynecology and Reproductive Biology
Day care versus inpatient management of nausea and vomiting of pregnancy: cost utility analysis of a randomised controlled trial
Optional Fields
Hyperemesis gravidarum Day care management Cost utility analysis Economic evaluation Markov model HYPEREMESIS GRAVIDARUM
Objective: To assess the comparative cost effectiveness of day care over inpatient management of nausea and vomiting of pregnancy (NVP).Study design: A cost utility analysis was performed using a decision analytical model in which a Markov model was constructed. The Markov model was primarily populated with data from a recently published randomised controlled trial. Which included pregnant women presenting to Cork University Maternity Hospital, a tertiary referral maternity hospital, seeking treatment for NVP. Costs and outcomes were estimated from the perspective of the Irish health service (HSE) and patients. A probabilistic sensitivity analysis, using a Monte Carlo simulation, was also performed. A Bayesian Value of Information analysis was used to estimate the value of collecting additional information.Results: When both the healthcare provider and patient's perspective was considered, day care management of NVP remained less costly (mean 985; 95% C.I. 705-1456 vs. 3837 (2124-8466)) and more effective (9.42; 4.19-12.25 vs. 9.49; 4.32-12.39 quality adjusted life years) compared with inpatient management. The Cost Effectiveness Acceptability Curve indicates the probability that day care management is 70% more cost effective compared to inpatient management at a ceiling ratio of 45,000 per QALY, indicating little decision uncertainty. The Bayesian Value of Information analysis indicates there is value in collecting further information; the Expected Value of Perfect Information (EVPI) is estimated to be 5.4 million.Conclusion: Day care management of NVP is cost effective compared to inpatient management. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
Grant Details