sFlt‐1/PlGF ratio test for pre‐eclampsia: an economic assessment for the UK

OBJECTIVES: To assess the economic impact of introducing into clinical practice in the UK the soluble fms‐like tyrosine kinase (sFlt‐1) to placental growth factor (PlGF) ratio test for guiding the management of pre‐eclampsia. METHODS: We used an economic model estimating the incremental value of information, from a UK National Health Service payer's perspective, generated by the sFlt‐1/PlGF ratio test, compared with current diagnostic procedures, in guiding the management of women with suspected pre‐eclampsia. The economic model estimated costs associated with the diagnosis and management of pre‐eclampsia in pregnant women between 24 + 0 and 36 + 6 weeks' gestation, managed in either a ‘test’ scenario in which the sFlt‐1/PlGF test is used in addition to current diagnostic procedures, or a ‘no‐test’ scenario in which clinical decisions are based on current diagnostic procedures alone. Test characteristics and resource use were derived from PROGNOSIS, a non‐interventional study in women presenting with clinical suspicion of pre‐eclampsia. The main outcome measure from the economic model was the cost per patient per episode of care, from first suspicion of pre‐eclampsia to birth. RESULTS: Introduction of the sFlt‐1/PlGF ratio test into clinical practice is expected to result in cost savings of £344 per patient compared with a no‐test scenario. Savings are generated primarily through an improvement in diagnostic accuracy and subsequent reduction in unnecessary hospitalization. CONCLUSIONS: Introducing the sFlt‐1/PlGF ratio test into clinical practice in the UK was shown to be cost‐saving by reducing unnecessary hospitalization of women at low risk of developing pre‐eclampsia. In addition, the test ensures that those women at higher risk are identified and managed appropriately. © 2016 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.