OBJECTIVE: To assess the cost-effectiveness of using magnesium sulphate for pre-eclampsia to prevent eclampsia. DESIGN: Multinational trial-based economic evaluation. SETTING: Thirty-three countries participating in the Magnesium Sulphate for Prevention of Eclampsia (Magpie) Trial. POPULATION: Women (9996) with pre-eclampsia from the Magpie Trial. METHODS: Outcome and hospital resource use data were available for the trial period from the Magpie Trial. Country-specific unit costs (U.S. dollar, year 2001) were obtained subsequently from participating hospitals by questionnaire. Cost-effectiveness was estimated for three categories of countries grouped by gross national income (GNI) into high, middle and low GNI countries using a regression model. Uncertainty was explored in sensitivity analyses. MAIN OUTCOME MEASURES: Eclampsia, hospital care costs and the incremental cost per case of eclampsia prevented. RESULTS: The number of women with pre-eclampsia who needed to receive magnesium sulphate to prevent one case of eclampsia was 324 [95% confidence interval (CI) 122, infinity] in high, 184 (95% CI 91, 6798) in middle and 43 (95% CI 30, 68) in low GNI countries. The additional hospital care cost per woman receiving magnesium sulphate was $65, $13 and $11, respectively. The incremental cost of preventing one case of eclampsia was $21,202 in high, $2473 in middle and $456 in low GNI countries. Reserving treatment for severe pre-eclampsia would lower these estimates to $12,942, $1179 and $263. CONCLUSIONS: Magnesium sulphate for pre-eclampsia costs less and prevents more eclampsia in low GNI than in high GNI countries. Cost-effectiveness substantially improves if it is used only for severe pre-eclampsia, or the purchase price is reduced in low GNI countries.
OBJECTIVE: To assess the cost-effectiveness of using magnesium sulphate for pre-eclampsia to prevent eclampsia. DESIGN: Multinational trial-based economic evaluation. SETTING: Thirty-three countries participating in the Magnesium Sulphate for Prevention of Eclampsia (Magpie) Trial. POPULATION: Women (9996) with pre-eclampsia from the Magpie Trial. METHODS: Outcome and hospital resource use data were available for the trial period from the Magpie Trial. Country-specific unit costs (U.S. dollar, year 2001) were obtained subsequently from participating hospitals by questionnaire. Cost-effectiveness was estimated for three categories of countries grouped by gross national income (GNI) into high, middle and low GNI countries using a regression model. Uncertainty was explored in sensitivity analyses. MAIN OUTCOME MEASURES: Eclampsia, hospital care costs and the incremental cost per case of eclampsia prevented. RESULTS: The number of women with pre-eclampsia who needed to receive magnesium sulphate to prevent one case of eclampsia was 324 [95% confidence interval (CI) 122, infinity] in high, 184 (95% CI 91, 6798) in middle and 43 (95% CI 30, 68) in low GNI countries. The additional hospital care cost per woman receiving magnesium sulphate was $65, $13 and $11, respectively. The incremental cost of preventing one case of eclampsia was $21,202 in high, $2473 in middle and $456 in low GNI countries. Reserving treatment for severe pre-eclampsia would lower these estimates to $12,942, $1179 and $263. CONCLUSIONS: Magnesium sulphate for pre-eclampsia costs less and prevents more eclampsia in low GNI than in high GNI countries. Cost-effectiveness substantially improves if it is used only for severe pre-eclampsia, or the purchase price is reduced in low GNI countries.
Authors: Gordon H Guyatt; Andrew D Oxman; Regina Kunz; Roman Jaeschke; Mark Helfand; Alessandro Liberati; Gunn E Vist; Holger J Schünemann Journal: BMJ Date: 2008-05-24
Authors: Jeffrey N Bone; Asif R Khowaja; Marianne Vidler; Beth A Payne; Mrutyunjaya B Bellad; Shivaprasad S Goudar; Ashalata A Mallapur; Khatia Munguambe; Rahat N Qureshi; Charfudin Sacoor; Esperanca Sevene; Geert W J Frederix; Zulfiqar A Bhutta; Craig Mitton; Laura A Magee; Peter von Dadelszen Journal: BMJ Glob Health Date: 2021-05
Authors: Zoë M McLaren; Alana Sharp; John P Hessburg; Amir Sabet Sarvestani; Ethan Parker; James Akazili; Timothy R B Johnson; Kathleen H Sienko Journal: Dev Eng Date: 2017-07-03