Implementing sFlt-1/PlGF ratio test for pre-eclampsia cuts unnecessary hospitalizations, costs

The ratio test based on a soluble fms-like tyrosine 1/placental growth factor (sFlt-1/PlGF) cutoff of ≤38 is likely to reduce unnecessary hospitalization in Asian women for pre-eclampsia and improve the identification of those who do need medical attention, leading to substantial cost savings for the healthcare system, reports a recent Japan study.

Cost analysis compared the no-test scenario, in which clinical decisions were based on standard diagnostic procedures alone, vs the test scenario, which combined the sFlt-1/PIGF ratio test with conventional procedures. Costs for maternal (hospitalization, outpatient, and lab tests) and neonatal (maternal corticosteroid treatment and neonatal intensive care) care were assessed.

Using data from 180 Japanese women, the researchers found that in the no-test scenario, 14.4 percent of women were hospitalized. SFlt-1/PlGF testing found that 79.4 percent had ratios ≤38, of whom 0.56 percent were hospitalized; of the remaining 20.6 percent with ratio values >38, 40 percent were hospitalized. The overall hospitalization rate in the test scenario was 8.7 percent.

Moreover, there were more women who were admitted before the onset of pre-eclampsia in the no-test vs test scenarios (4,476 vs 2,691). Of the women hospitalized, pre-eclampsia manifested in 41.4 percent in the test scenario as opposed to only 24.1 percent in the no-test scenario.

Totaling across maternal and neonatal care costs, the introduction of the sFlt-1/PlGF ratio test yielded cost savings of JPY 16,373 per patient vs nontesting. Savings were mostly from reductions in hospitalization.

“Our economic analysis demonstrates that implementing the sFlt-1/PlGF ratio test for the management of women with suspected pre-eclampsia in Japan may reduce unnecessary hospitalizations. Furthermore, reducing unnecessary hospitalizations is associated with cost savings for Japanese healthcare providers,” the researchers said.