An Economic Evaluation of the Community Benefit of the Australian Pregnancy Register of Antiepileptic Drugs
Abstract number :
2.42
Submission category :
16. Epidemiology
Year :
2021
Submission ID :
1886443
Source :
www.aesnet.org
Presentation date :
12/9/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:56 AM
Authors :
ZANFINA ADEMI, MPharm, MPH, PhD - Monash University; Piero Perucca, Associate Professor – Central Clinical School – Monash University; Alison Hitchcock, Doctor – Royal Melbourne Hospital; Janet E. Graham, Registered Nurse – University of Melbourne; Clara Marquina, PhD Candidate Public Health (Health Economics) – School of Public Health – Monash University; Danny Liew, MBBS, PhD – Deputy Head of the School, School of Public Health and Preventive Medicine, Monash University; Terence O’Brien, MBBS, MD, FRACP, FRCPE, FAHMS, FAE – Head of the Central Clinical School, Central Clinical School, Monash University; Frank Vajda, Neurologist (Brain Specialist) – Professor, Medicine, Dentistry and Health Sciences, University of Melbourne
Rationale: The Raoul Wallenberg Australian Pregnancy Register (APR) was established in 1999 to collect, analyse and publish data on the risks to babies exposed to Antiepileptic Drugs (AEDs) and to facilitate possible quality improvements in management care over time. It is one of a few prospective observational pregnancy registers of AEDs that has been established around the world. No study has examined the cost-effectiveness of such registers. Here we aimed to evaluate the clinical and economic impacts of the APR from both societal and healthcare system perspectives.
Methods: Using decision analytic modelling, we estimated the effectiveness (prevention of adverse pregnancy outcomes) and costs (costs of adverse pregnancy outcomes and the register itself) of the APR over a 20-year time horizon (2000-2019). The adverse outcomes were stillbirth, birth defects and induced abortion. All cost data were derived from published sources. The health and cost impacts were then extrapolated to the total target Australian epilepsy population. In the base-case analysis, the comparator was referred to the Register data from 1998 to 2002. The outcomes of interest were the return of investment (ROI) for the APR and incremental cost effectiveness ratio (ICER) in terms of cost per adverse outcome avoided.
Results: Over the 20-year time horizon, the ROI from the APR from a societal perspective was AU$1,661 (i.e. every dollar spent on the program resulted in a return of AU$1,661). Over this time, it was estimated that there were 9,609 adverse pregnancy outcomes avoided, and healthcare and societal costs were reduced by AU$191 milion and AU$6.6 billion, respectively. Hence from a health economic point of view, the APR was dominant (i.e. both health and cost saving), and ICERs were not relevant to calculate. This conclusion was stable to sensitivity analyses.
Conclusions: The APR represents excellent value for investment for Australian being not only health saving, but also cost saving from a societal and a healthcare perspective.
Funding: Please list any funding that was received in support of this abstract.: This research received no specific grant from any funding agency in the public or commercial.
Epidemiology