Cost effectiveness
In the base case deterministic analysis, the FMF algorithm is associated with an overall cost saving of £9.06 per pregnancy screened and a QALY gain of 0.00006 when compared to standard care using the NICE screening method. care. With a cohort of 5957 pregnant women, the use of the FMF algorithm resulted in 7 fewer estimated cases of preterm PE (41) versus 48 pre-term PE cases with the NICE algorithm. Across a cohort of 5957 women the expected cost saving would be approximately £54,000. Overall, the number of QALYs over a one-year time horizon was similar across the two interventions, reflecting the fact that serious adverse events such as stillbirth are relatively rare.
Figure 1 illustrates the distribution of incremental cost and QALY outcomes from the probabilistic sensitivity analysis on a cost-effectiveness plane with each dot representing a simulation of the model accounting for parameter uncertainty. The values predominantly fall within the north-western quadrant where FMF screening is associated with greater cost-savings and health gains when compared to the NICE method. The FMF screening method is cost saving in 67% of simulations (Figure 1).