Gestational diabetes screening with the new IADPSG guidelines: a cost-effectiveness analysis
American Journal of Obstetrics and Gynecology, 07/03/2012
Mission JF et al. – Screening at 24–28 weeks GA under the new IADPSG guidelines with the 2h GTT is expensive but cost–effective in improving maternal and neonatal outcomes. How the health care system will provide expanded care to this group of women will need to be examined.Methods
- A decision analytic model was built comparing routine screening with the 2h OGTT vs. the 1–hour GCT.
- All probabilities, costs, and benefits were derived from the literature.
- Base–case, sensitivity analyses, and a Monte Carlo simulation were performed.
- Screening with the 2h GTT was more expensive, more effective, and cost–effective at $61,503/QALY.
- In a one–way sensitivity analysis, the more inclusive IADPSG diagnostic approach remained cost–effective as long an additional 2.0% or more of patients were diagnosed and treated for GDM.