Cost-Effectiveness Analysis of Varicella Pneumonia Prevention Strategies
Author Information
Author(s): George A. Macones, Stephanie Ewing, Neil S. Silverman
Primary Institution: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine
Hypothesis
What is the cost-effectiveness of different strategies for preventing maternal varicella pneumonia during pregnancy?
Conclusion
Routine serologic testing for varicella immunity should not be performed, as it is the most costly strategy with no additional benefit compared to other options.
Supporting Evidence
- Routine serologic testing was the most costly strategy with no demonstrable increase in benefit.
- Post-exposure testing with targeted VZIG and untargeted VZIG administration were similar in cost and effectiveness.
- The study suggests that empiric post-exposure treatment is the most cost-effective option where rapid testing is unavailable.
Takeaway
This study looked at different ways to prevent a serious illness in pregnant women caused by chickenpox and found that one common method is too expensive and doesn't help.
Methodology
A decision tree was constructed to compare three strategies: routine serologic testing followed by targeted VZIG prophylaxis, post-exposure serologic testing followed by targeted VZIG prophylaxis, and untargeted post-exposure VZIG administration.
Potential Biases
Assumptions made regarding the efficacy of VZIG and the absence of severe adverse effects could introduce bias.
Limitations
The study relied on estimates from older data and expert opinions, and the cost calculations may overestimate true costs due to not all cases resulting in hospitalization.
Participant Demographics
Pregnant women with negative or uncertain histories of varicella infection.
Want to read the original?
Access the complete publication on the publisher's website