Cost‐effectiveness of induction of labour at term with a Foley catheter compared to vaginal prostaglandin E2 gel (PROBAAT trial). Issue 8 (26th March 2013)

• Record Type: Journal Article
• Authors: van, GJ; Jozwiak, M; Opmeer, BC; Oude Rengerink, K; Benthem, M; Dijksterhuis, MGK; van, ME; van der, PCM; Schuitemaker, NWE; Papatsonis, DNM; Perquin, DAM; Porath, M; van der, JAM; Rijnders, RJP; Scheepers, HCJ; Spaanderman, M; van, MG; de, JW; Mol, BWJ; Bloemenkamp, KWM
• Is Part Of: BJOG. Volume 120:Issue 8(2013:Aug.)
• Page Start: 987
• Page End: 995
• Publication Date: 2013-03-26
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.12221
• Languages: English
• ISSNs: 1470-0328

Abstract

<abstract abstract-type="main" xml:lang="en" id="bjo12221-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bjo12221-sec-0001" sec-type="section"> <title>Objective</title> <p>To assess the economic consequences of labour induction with Foley catheter compared to prostaglandin E<sub>2</sub> gel.</p> </sec> <sec id="bjo12221-sec-0002" sec-type="section"> <title>Design</title> <p>Economic evaluation alongside a randomised controlled trial.</p> </sec> <sec id="bjo12221-sec-0003" sec-type="section"> <title>Setting</title> <p>Obstetric departments of one university and 11 teaching hospitals in the Netherlands.</p> </sec> <sec id="bjo12221-sec-0004" sec-type="section"> <title>Population</title> <p>Women scheduled for labour induction with a singleton pregnancy in cephalic presentation at term, intact membranes and an unfavourable cervix; and without previous caesarean section.</p> </sec> <sec id="bjo12221-sec-0005" sec-type="section"> <title>Methods</title> <p>Cost‐effectiveness analysis from a hospital perspective.</p> </sec> <sec id="bjo12221-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>We estimated direct medical costs associated with healthcare utilisation from randomisation to 6 weeks postpartum. For caesarean section rate, and maternal and neonatal morbidity we calculated the incremental cost‐effectiveness ratios, which represent the costs to prevent one of these adverse outcomes.</p> </sec> <sec id="bjo12221-sec-0007" sec-type="section"> <title>Results</title> <p>Mean costs per woman in the Foley catheter group (<italic>n</italic> = 411) and in the prostaglandin E<sub>2</sub> gel group (<italic>n</italic> = 408), were €3297 versus €3075, respectively, with an average difference of €222 (95% confidence interval −€157 to €633). In the Foley catheter group we observed higher costs due to longer labour ward occupation and less cost related to induction material and neonatal admissions. Foley catheter induction showed a comparable caesarean section rate compared with prostaglandin induction, therefore the incremental cost‐effectiveness ratio was not informative. Foley induction resulted in fewer neonatal admissions (incremental cost‐effectiveness ratio €2708) and asphyxia/postpartum haemorrhage (incremental cost‐effectiveness ratios €5257) compared with prostaglandin induction.</p> </sec> <sec id="bjo12221-sec-0008" sec-type="section"> <title>Conclusions</title> <p>Foley catheter and prostaglandin E<sub>2</sub> labour induction generate comparable costs.</p> </sec> </abstract>