Elective cesarean delivery to prevent perinatal transmission of hepatitis C virus: A cost-effectiveness analysis

Beth A. Plunkett, William A Grobman

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

This study was undertaken to determine whether elective cesarean delivery to avert perinatal hepatitis C virus (HCV) transmission is cost-effective. Using decision analysis, we compared 2 approaches: (1) offering elective cesarean delivery to avert perinatal HCV transmission, (2) performing a cesarean delivery only for obstetric indications. Lifetime cost and quality-adjusted-life-years (QALYs) for HCV-infected neonates were evaluated with Markov analysis. We assumed elective cesarean delivery reduces perinatal HCV transmission, and we varied both the risk reduction caused by elective cesarean delivery and the background risk of perinatal HCV infection. When elective cesarean section prevents all perinatal HCV transmission, 18 elective cesarean deliveries are necessary to avert 1 neonatal infection with a cost-effectiveness ratio of $34,812/QALY. At a background perinatal transmission rate of 7.7% elective cesarean deliveries is cost-effective only if it reduces the risk of perinatal transmission by more than 77%. Elective cesarean delivery is cost-effective only if it substantially reduces the risk of perinatal HCV transmission.

Original languageEnglish (US)
Pages (from-to)998-1003
Number of pages6
JournalAmerican journal of obstetrics and gynecology
Volume191
Issue number3
DOIs
StatePublished - Sep 1 2004

Keywords

  • Cost-effective
  • Hepatitis C
  • Perinatal transmission

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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