Cost effectiveness of calcium supplement in reducing preeclampsia-related maternal mortality in Colombia
Cost effectiveness of calcium supplement in reducing preeclampsia-related maternal mortality in Colombia
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DOI：
10.15446/rsap.v18n2.48776
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发表时间：
2016-03-01
期刊：
影响因子：
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通讯作者：
Gómez-Sánchez, Pío Iván
中科院分区：
文献类型：
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作者：
Chicaíza-Becerra, Liliana A;García-Molina, Mario;Gómez-Sánchez, Pío Iván
目的 评估从怀孕第 14 周开始向所有孕妇服用钙（每天 1200 毫克）与不服用钙以降低先兆子痫发生率相比的成本效益。方法 在 TreeAge 中构建决策树，以与孕产妇死亡减少相关的获得生命年 (LYG) 来衡量结果。成本是从哥伦比亚卫生系统的角度考虑的，并在 2014 年以哥伦比亚比索表示 (COP)。折扣率为0%。我们对成本和有效性进行了敏感性单变量和概率分析。结果 与不干预相比，补钙是主要的替代方案。如果先兆子痫的发病率低于每 1 000 名孕妇 51.7 例，或者每片 600 毫克钙的成本高于 COP $507.85，则在哥伦比亚，钙补充剂不再是一种具有成本效益的替代方案，门槛为 COP $ 45 026 379（哥伦比亚人均 GDP 的 3 倍，2013 年每 LYG）。结论 与不干预相比，从妊娠第 14 周开始向所有孕妇补钙是一种主要替代方案，可节省 200 LYG，同时将成本降低至每 100,000 名孕妇 59.33 亿哥伦比亚比索。
Objectives To estimate the cost-effectiveness of administering calcium (1200 mg per day) starting in week 14 of pregnancy to all pregnant women compared to not supplying it to reduce the incidence of preeclampsia. Methods A decision tree was built in TreeAge with outcome measured in life years gained (LYG) associated with the reduction in maternal deaths. Costs were included from the perspective of the health system in Colombia and expressed in Colombian pesos in 2014 (COP). The discount rate was 0 %. We performed sensitivity univariate and probabilistic analyses for costs and effectiveness. Results Compared to no intervention, calcium supplement is a dominant alternative. If the incidence of preeclampsia is lower than 51.7 per 1 000 pregnant women or the cost per tablet of calcium of 600 mg is greater than COP $507.85, calcium supplement is no longer a cost-effective alternative in Colombia for a threshold of COP $ 45 026 379 (3 times the Colombian per capita GDP of 2013 per LYG). Conclusions Supplying calcium to all pregnant women from week 14 of gestation is a dominant alternative compared to no intervention, which saves 200 LYG, while it decreases costs to the order of COP$5 933 million per 100.000 pregnant women.