Cost-effectiveness of low-dose aspirin for the prevention of preterm birth: a prospective study of the Global Network for Women's and Children's Health Research

dc.contributor.authorPatterson, Jackie K.
dc.contributor.authorNeuwahl, Simon
dc.contributor.authorGoco, Norman
dc.contributor.authorMoore, Janet
dc.contributor.authorGoudar, Shivaprasad S.
dc.contributor.authorDerman, Richard J.
dc.contributor.authorHoffman, Matthew
dc.contributor.authorMetgud, Mrityunjay
dc.contributor.authorSomannavar, Manjunath
dc.contributor.authorKavi, Avinash
dc.contributor.authorOkitawutshu, Jean
dc.contributor.authorLokangaka, Adrien
dc.contributor.authorTshefu, Antoinette
dc.contributor.authorBose, Carl L.
dc.contributor.authorMwapule, Abigail
dc.contributor.authorMwenechanya, Musaku
dc.contributor.authorChomba, Elwyn
dc.contributor.authorCarlo, Waldemar A.
dc.contributor.authorChicuy, Javier
dc.contributor.authorFigueroa, Lester
dc.contributor.authorKrebs, Nancy F.
dc.contributor.authorJessani, Saleem
dc.contributor.authorSaleem, Sarah
dc.contributor.authorGoldenberg, Robert L.
dc.contributor.authorKurhe, Kunal
dc.contributor.authorDas, Prabir
dc.contributor.authorPatel, Archana
dc.contributor.authorHibberd, Patricia L.
dc.contributor.authorAchieng, Emmah
dc.contributor.authorNyongesa, Paul
dc.contributor.authorEsamai, Fabian
dc.contributor.authorBucher, Sherri
dc.contributor.authorLiechty, Edward A.
dc.contributor.authorBresnahan, Brian W.
dc.contributor.authorKoso-Thomas, Marion
dc.contributor.authorMcClure, Elizabeth M.
dc.contributor.departmentPediatrics, School of Medicine
dc.date.accessioned2024-09-09T14:10:30Z
dc.date.available2024-09-09T14:10:30Z
dc.date.issued2023
dc.description.abstractBackground: Premature birth is associated with an increased risk of mortality and morbidity, and strategies to prevent preterm birth are few in number and resource intensive. In 2020, the ASPIRIN trial showed the efficacy of low-dose aspirin (LDA) in nulliparous, singleton pregnancies for the prevention of preterm birth. We sought to investigate the cost-effectiveness of this therapy in low-income and middle-income countries. Methods: In this post-hoc, prospective, cost-effectiveness study, we constructed a probabilistic decision tree model to compare the benefits and costs of LDA treatment compared with standard care using primary data and published results from the ASPIRIN trial. In this analysis from a health-care sector perspective, we considered the costs and effects of LDA treatment, pregnancy outcomes, and neonatal health-care use. We did sensitivity analyses to understand the effect of the price of the LDA regimen, and the effectiveness of LDA in reducing both preterm birth and perinatal death. Findings: In model simulations, LDA was associated with 141 averted preterm births, 74 averted perinatal deaths, and 31 averted hospitalisations per 10 000 pregnancies. The reduction in hospitalisation resulted in a cost of US$248 per averted preterm birth, $471 per averted perinatal death, and $15·95 per disability-adjusted life year. Interpretation: LDA treatment in nulliparous, singleton pregnancies is a low-cost, effective treatment to reduce preterm birth and perinatal death. The low cost per disability-adjusted life year averted strengthens the evidence in support of prioritising the implementation of LDA in publicly funded health care in low-income and middle-income countries.
dc.eprint.versionAuthor's manuscript
dc.identifier.citationPatterson JK, Neuwahl S, Goco N, et al. Cost-effectiveness of low-dose aspirin for the prevention of preterm birth: a prospective study of the Global Network for Women's and Children's Health Research. Lancet Glob Health. 2023;11(3):e436-e444. doi:10.1016/S2214-109X(22)00548-4
dc.identifier.urihttps://hdl.handle.net/1805/43216
dc.language.isoen_US
dc.publisherElsevier
dc.relation.isversionof10.1016/S2214-109X(22)00548-4
dc.relation.journalThe Lancet Global Health
dc.rightsPublisher Policy
dc.sourcePMC
dc.subjectAspirin
dc.subjectChild health
dc.subjectCost-benefit analysis
dc.subjectNewborn infant
dc.subjectPerinatal death
dc.subjectPregnancy
dc.subjectPremature birth
dc.subjectWomen's health
dc.titleCost-effectiveness of low-dose aspirin for the prevention of preterm birth: a prospective study of the Global Network for Women's and Children's Health Research
dc.typeArticle
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