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Study of progesterone for the prevention of preterm birth in twins (STOPPIT): Findings from a trial-based cost-effectiveness analysis

Published online by Cambridge University Press:  15 April 2010

Oya Eddama ,
Stavros Petrou ,
Dean Regier ,
John Norrie ,
Graeme MacLennan ,
Fiona Mackenzie  and
Jane E. Norman
Oya Eddama
Affiliation:
University of Oxford
Stavros Petrou
Affiliation:
University of Oxford
Dean Regier
Affiliation:
University of Oxford
John Norrie
Affiliation:
University of Glasgow
Graeme MacLennan
Affiliation:
University of Aberdeen
Fiona Mackenzie
Affiliation:
Princess Royal Maternity Hospital
Jane E. Norman
Affiliation:
University of Edinburgh
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Abstract

Objectives: Preterm birth contributes to a range of healthcare problems amongst infants surmounting to sizeable healthcare costs. Twin pregnancies are at particular risk of preterm birth. The objective of this study was to assess the cost-effectiveness of vaginal progesterone gel for the prevention of preterm birth in twin pregnancies.

Methods: An economic evaluation was conducted alongside a randomized placebo controlled trial (the STOPPIT trial) of vaginal progesterone gel for the prevention of preterm birth in twin pregnancies. Five hundred women were recruited from nine maternity hospitals in the United Kingdom. The outcomes of the economic evaluation were presented in terms of net benefit statistics, cost-effectiveness acceptability curves, generated using the nonparametric bootstrap method, and the expected value of perfect information.

Results: Mean health service costs between the period of randomization and discharge for mother and infant were £28,031 in the progesterone group and £25,972 in the placebo group, generating a mean nonsignificant cost difference of £2,059 (bootstrap mean cost difference £2,334; 95 percent confidence interval: −£5,023, £9,142; p = .33). The probability of progesterone being cost-effective was 20 percent at a willingness to pay threshold of £30,000 per preterm birth prevented. There is little economic justification for conducting further research into the use of vaginal progesterone gel in twin pregnancies for the prevention of preterm birth.

Conclusions: Further studies of preventive interventions for preterm birth more generally are required given the scale of the clinical and economic burden of this condition. These studies should be sufficiently powered for economic endpoints and extend beyond hospital discharge.

Keywords

ObstetricsEconomic evaluationCost-effectiveness analysisValue of information
Type
ASSESSMENTS
Information
International Journal of Technology Assessment in Health Care , Volume 26 , Issue 2 , April 2010 , pp. 141 - 148
Copyright
Copyright © Cambridge University Press 2010

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