Cost-effectiveness analysis of polycystic ovary syndrome management and the risk of gestational diabetes in pregnant women: a decision-tree model. (3rd September 2021)

• Record Type: Journal Article
• Authors: Alenzi, Ebtihag O.
• Is Part Of: Expert review of pharmacoeconomics & outcomes research. Volume 21:Number 5(2021)
• Page Start: 995
• Page End: 999
• Publication Date: 2021-09-03
• Subjects: PCOS -- metformin -- GDM -- pregnancy -- cost-effectiveness -- decision tree; Pharmacology -- Economic aspects -- Periodicals; 338.47615105
• DOI: 10.1080/14737167.2020.1819796
• Languages: English
• ISSNs: 1473-7167

Abstract

ABSTRACT: Background: This study estimated the cost-effectiveness of metformin to reduce the risk of gestational diabetes mellitus (GDM) in pregnant women with polycystic ovary syndrome (PCOS) from the US health-care payer perspective. Methods: A decision tree was developed to simulate the progression of PCOS in a hypothetical cohort of 10, 000 pregnant women diagnosed with PCOS and two scenarios were tested. Normal glucose regulation without developing GDM, average cost-effectiveness ratios (ACER), and the incremental cost-effectiveness ratios (ICERs) were the outcome measures assessed through pregnancy. Evidence from randomized clinical trials and other published literature were used to assess disease progression and its associated health-care costs. Sensitivity analyses that varied key model parameters were conducted. Results: Management of PCOS with metformin was associated with lowest ACER ($669.78 per normal glucose regulation without GDM) as compared to 'no intervention' strategy. Metformin use is the most cost-effective strategy to manage PCOS during pregnancy with average cost savings of $7, 593, 372.97 and an average effect gain of 2271 of normal glucose regulation without GDM among pregnant women with PCOS. Sensitivity analyses determined that the results are robust. Conclusions: Management of PCOS during pregnancy may be a cost-effective strategy to reduce GDM risk and its associated complications.