Approaches Compared for Aspirin Prophylaxis for Preeclampsia
(HealthDay News) — The best approaches to low-dose aspirin prophylaxis for the prevention of preeclampsia seem to be the U.S. Preventive Services Task Force (USPSTF) recommendations and universal prophylaxis, according to a study published online Nov. 5 in Obstetrics & Gynecology.
Erika F. Werner, MD, from the Alpert Medical School of Brown University in Providence, RI, and colleagues created a decision model to examine four approaches to aspirin prophylaxis for the prevention of preeclampsia in the United States.
The researchers found that the estimated rate of preeclampsia would be 4.18% without prophylaxis, compared to 4.17%, 3.83%, and 3.81% with the American College of Obstetricians and Gynecologists (the College) approach, the USPSTF approach, and with universal prophylaxis, respectively. Assuming four million births per year, the USPSTF approach would save $377.4 million in direct medical care costs annually, while universal prophylaxis would save $365 million compared with no prophylaxis. In 79% of probabilistic simulations, the USPSTF approach was the most cost beneficial. The universal approach was the most cost-effective in more than 99% of simulations, assuming a willingness to pay of $100,000 per neonatal quality-adjusted life-year gained.
"Both the USPSTF approach and universal prophylaxis would reduce morbidity, save lives, and lower health care costs in the United States to a much greater degree than the approach currently recommended by the College," the authors write.