Placental growth factor testing for suspected pre-eclampsia: a cost-effectiveness analysis

Objective To calculate the cost-effectiveness of implementing PlGF testing alongside a clinical management algorithm in maternity services in the UK, compared with current standard care. Design Cost-effectiveness analysis. Setting Eleven maternity units participating in the PARROT stepped-wedge cluster-randomised controlled trial. Population Women presenting with suspected pre-eclampsia between 20(+0) and 36(+6) weeks' gestation. Methods Monte Carlo simulation utilising resource use data and maternal adverse outcomes. Main outcome measures Cost per maternal adverse outcome prevented. Results Clinical care with PlGF testing costs less than current standard practice and resulted in fewer maternal adverse outcomes. There is a total cost-saving of UK 149 pound per patient tested, when including the cost of the test. This represents a potential cost-saving of UK 2,891,196 pound each year across the NHS in England. Conclusions Clinical care with PlGF testing is associated with the potential for cost-savings per participant tested when compared with current practice via a reduction in outpatient attendances, and improves maternal outcomes. This economic analysis supports a role for implementation of PlGF testing in antenatal services for the assessment of women with suspected pre-eclampsia. Tweetable abstract Placental growth factor testing for suspected pre-eclampsia is cost-saving and improves maternal outcomes.