Huntington, S;
Weston, G;
Seedat, F;
Marshall, J;
Bailey, H;
Tebruegge, M;
Ahmed, I;
... Adams, E; + view all
(2020)
Repeat screening for syphilis in pregnancy as an alternative screening strategy in the UK: a cost-effectiveness analysis.
BMJ Open
, 10
(11)
, Article e038505. 10.1136/bmjopen-2020-038505.
Preview |
Text
e038505.full.pdf - Published Version Download (1MB) | Preview |
Abstract
Objectives: To assess the cost-effectiveness of universal repeat screening for syphilis in late pregnancy, compared with the current strategy of single screening in early pregnancy with repeat screening offered only to high-risk women. Design: A decision tree model was developed to assess the incremental costs and health benefits of the two screening strategies. The base case analysis considered short-term costs during the pregnancy and the initial weeks after delivery. Deterministic and probabilistic sensitivity analyses and scenario analyses were conducted to assess the robustness of the results. Setting: UK antenatal screening programme. Population: Hypothetical cohort of pregnant women who access antenatal care and receive a syphilis screen in 1 year. Primary and secondary outcome measures: The primary outcome was the cost to avoid one case of congenital syphilis (CS). Secondary outcomes were the cost to avoid one case of intrauterine fetal demise (IUFD) or neonatal death and the number of women needing to be screened/treated to avoid one case of CS, IUFD or neonatal death. The cost per quality-adjusted life year gained was assessed in scenario analyses. Results: Base case results indicated that for pregnant women in the UK (n=725 891), the repeat screening strategy would result in 5.5 fewer cases of CS (from 8.8 to 3.3), 0.1 fewer cases of neonatal death and 0.3 fewer cases of IUFD annually compared with the single screening strategy. This equates to an additional £1.8 million per case of CS prevented. When lifetime horizon was considered, the incremental cost-effectiveness ratio for the repeat screening strategy was £120 494. Conclusions: Universal repeat screening for syphilis in pregnancy is unlikely to be cost-effective in the current UK setting where syphilis prevalence is low. Repeat screening may be cost-effective in countries with a higher syphilis incidence in pregnancy, particularly if the cost per screen is low.
| Type: | Article |
|---|---|
| Title: | Repeat screening for syphilis in pregnancy as an alternative screening strategy in the UK: a cost-effectiveness analysis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/bmjopen-2020-038505 |
| Publisher version: | http://dx.doi.org/10.1136/bmjopen-2020-038505 |
| Language: | English |
| Additional information: | This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10116148 |
Archive Staff Only
 |
View Item |
