Cost-effectiveness of induction of labour at term with a Foley catheter compared to vaginal prostaglandin E₂ gel (PROBAAT trial)

G J van Baaren; M Jozwiak; B C Opmeer; K Oude Rengerink; M Benthem; M G K Dijksterhuis; M E van Huizen; P C M van der Salm; N W E Schuitemaker; D N M Papatsonis; D A M Perquin; M Porath; J A M van der Post; R J P Rijnders; H C J Scheepers; M Spaanderman; M G van Pampus; J W de Leeuw; B W J Mol; K W M Bloemenkamp

doi:10.1111/1471-0528.12221

Cost-effectiveness of induction of labour at term with a Foley catheter compared to vaginal prostaglandin E₂ gel (PROBAAT trial)

G J van Baaren
, M Jozwiak
, B C Opmeer
, K Oude Rengerink
, M Benthem
, M G K Dijksterhuis
, M E van Huizen
, P C M van der Salm
, N W E Schuitemaker
, D N M Papatsonis
, D A M Perquin
, M Porath
, J A M van der Post
, R J P Rijnders
, H C J Scheepers
, M Spaanderman
, M G van Pampus
, J W de Leeuw
, B W J Mol
, K W M Bloemenkamp

Julius Center, dept. Epidemiology & Health Economics

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: To assess the economic consequences of labour induction with Foley catheter compared to prostaglandin E2 gel.

DESIGN: Economic evaluation alongside a randomised controlled trial.

SETTING: Obstetric departments of one university and 11 teaching hospitals in the Netherlands.

POPULATION: Women scheduled for labour induction with a singleton pregnancy in cephalic presentation at term, intact membranes and an unfavourable cervix; and without previous caesarean section.

METHODS: Cost-effectiveness analysis from a hospital perspective.

MAIN OUTCOME MEASURES: We estimated direct medical costs associated with healthcare utilisation from randomisation to 6 weeks postpartum. For caesarean section rate, and maternal and neonatal morbidity we calculated the incremental cost-effectiveness ratios, which represent the costs to prevent one of these adverse outcomes.

RESULTS: Mean costs per woman in the Foley catheter group (n = 411) and in the prostaglandin E₂ gel group (n = 408), were €3297 versus €3075, respectively, with an average difference of €222 (95% confidence interval -€157 to €633). In the Foley catheter group we observed higher costs due to longer labour ward occupation and less cost related to induction material and neonatal admissions. Foley catheter induction showed a comparable caesarean section rate compared with prostaglandin induction, therefore the incremental cost-effectiveness ratio was not informative. Foley induction resulted in fewer neonatal admissions (incremental cost-effectiveness ratio €2708) and asphyxia/postpartum haemorrhage (incremental cost-effectiveness ratios €5257) compared with prostaglandin induction.

CONCLUSIONS: Foley catheter and prostaglandin E2 labour induction generate comparable costs.

Original language	English
Pages (from-to)	987-95
Number of pages	9
Journal	BJOG - An International Journal of Obstetrics and Gynaecology
Volume	120
Issue number	8
DOIs	https://doi.org/10.1111/1471-0528.12221
Publication status	Published - Jul 2013

Keywords

Administration, Intravaginal
Adult
Catheters
Cesarean Section
Cost-Benefit Analysis
Dinoprostone
Female
Humans
Labor, Induced
Netherlands
Pregnancy
Urinary Catheterization
Vaginal Creams, Foams, and Jellies

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10.1111/1471-0528.12221

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van Baaren, G. J., Jozwiak, M., Opmeer, B. C., Oude Rengerink, K., Benthem, M., Dijksterhuis, M. G. K., van Huizen, M. E., van der Salm, P. C. M., Schuitemaker, N. W. E., Papatsonis, D. N. M., Perquin, D. A. M., Porath, M., van der Post, J. A. M., Rijnders, R. J. P., Scheepers, H. C. J., Spaanderman, M., van Pampus, M. G., de Leeuw, J. W., Mol, B. W. J., & Bloemenkamp, K. W. M. (2013). Cost-effectiveness of induction of labour at term with a Foley catheter compared to vaginal prostaglandin E₂ gel (PROBAAT trial). BJOG - An International Journal of Obstetrics and Gynaecology, 120(8), 987-95. https://doi.org/10.1111/1471-0528.12221

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title = "Cost-effectiveness of induction of labour at term with a Foley catheter compared to vaginal prostaglandin E₂ gel (PROBAAT trial)",

abstract = "OBJECTIVE: To assess the economic consequences of labour induction with Foley catheter compared to prostaglandin E2 gel.DESIGN: Economic evaluation alongside a randomised controlled trial.SETTING: Obstetric departments of one university and 11 teaching hospitals in the Netherlands.POPULATION: Women scheduled for labour induction with a singleton pregnancy in cephalic presentation at term, intact membranes and an unfavourable cervix; and without previous caesarean section.METHODS: Cost-effectiveness analysis from a hospital perspective.MAIN OUTCOME MEASURES: We estimated direct medical costs associated with healthcare utilisation from randomisation to 6 weeks postpartum. For caesarean section rate, and maternal and neonatal morbidity we calculated the incremental cost-effectiveness ratios, which represent the costs to prevent one of these adverse outcomes.RESULTS: Mean costs per woman in the Foley catheter group (n = 411) and in the prostaglandin E₂ gel group (n = 408), were €3297 versus €3075, respectively, with an average difference of €222 (95\% confidence interval -€157 to €633). In the Foley catheter group we observed higher costs due to longer labour ward occupation and less cost related to induction material and neonatal admissions. Foley catheter induction showed a comparable caesarean section rate compared with prostaglandin induction, therefore the incremental cost-effectiveness ratio was not informative. Foley induction resulted in fewer neonatal admissions (incremental cost-effectiveness ratio €2708) and asphyxia/postpartum haemorrhage (incremental cost-effectiveness ratios €5257) compared with prostaglandin induction.CONCLUSIONS: Foley catheter and prostaglandin E2 labour induction generate comparable costs.",

keywords = "Administration, Intravaginal, Adult, Catheters, Cesarean Section, Cost-Benefit Analysis, Dinoprostone, Female, Humans, Labor, Induced, Netherlands, Pregnancy, Urinary Catheterization, Vaginal Creams, Foams, and Jellies",

author = "\{van Baaren\}, \{G J\} and M Jozwiak and Opmeer, \{B C\} and \{Oude Rengerink\}, K and M Benthem and Dijksterhuis, \{M G K\} and \{van Huizen\}, \{M E\} and \{van der Salm\}, \{P C M\} and Schuitemaker, \{N W E\} and Papatsonis, \{D N M\} and Perquin, \{D A M\} and M Porath and \{van der Post\}, \{J A M\} and Rijnders, \{R J P\} and Scheepers, \{H C J\} and M Spaanderman and \{van Pampus\}, \{M G\} and \{de Leeuw\}, \{J W\} and Mol, \{B W J\} and Bloemenkamp, \{K W M\}",

note = "{\textcopyright} 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology {\textcopyright} 2013 RCOG.",

year = "2013",

month = jul,

doi = "10.1111/1471-0528.12221",

language = "English",

volume = "120",

pages = "987--95",

journal = "BJOG - An International Journal of Obstetrics and Gynaecology",

issn = "1470-0328",

publisher = "John Wiley \& Sons Inc.",

number = "8",

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van Baaren, GJ, Jozwiak, M, Opmeer, BC, Oude Rengerink, K, Benthem, M, Dijksterhuis, MGK, van Huizen, ME, van der Salm, PCM, Schuitemaker, NWE, Papatsonis, DNM, Perquin, DAM, Porath, M, van der Post, JAM, Rijnders, RJP, Scheepers, HCJ, Spaanderman, M, van Pampus, MG, de Leeuw, JW, Mol, BWJ & Bloemenkamp, KWM 2013, 'Cost-effectiveness of induction of labour at term with a Foley catheter compared to vaginal prostaglandin E₂ gel (PROBAAT trial)', BJOG - An International Journal of Obstetrics and Gynaecology, vol. 120, no. 8, pp. 987-95. https://doi.org/10.1111/1471-0528.12221

TY - JOUR

T1 - Cost-effectiveness of induction of labour at term with a Foley catheter compared to vaginal prostaglandin E₂ gel (PROBAAT trial)

AU - van Baaren, G J

AU - Jozwiak, M

AU - Opmeer, B C

AU - Oude Rengerink, K

AU - Benthem, M

AU - Dijksterhuis, M G K

AU - van Huizen, M E

AU - van der Salm, P C M

AU - Schuitemaker, N W E

AU - Papatsonis, D N M

AU - Perquin, D A M

AU - Porath, M

AU - van der Post, J A M

AU - Rijnders, R J P

AU - Scheepers, H C J

AU - Spaanderman, M

AU - van Pampus, M G

AU - de Leeuw, J W

AU - Mol, B W J

AU - Bloemenkamp, K W M

PY - 2013/7

Y1 - 2013/7

N2 - OBJECTIVE: To assess the economic consequences of labour induction with Foley catheter compared to prostaglandin E2 gel.DESIGN: Economic evaluation alongside a randomised controlled trial.SETTING: Obstetric departments of one university and 11 teaching hospitals in the Netherlands.POPULATION: Women scheduled for labour induction with a singleton pregnancy in cephalic presentation at term, intact membranes and an unfavourable cervix; and without previous caesarean section.METHODS: Cost-effectiveness analysis from a hospital perspective.MAIN OUTCOME MEASURES: We estimated direct medical costs associated with healthcare utilisation from randomisation to 6 weeks postpartum. For caesarean section rate, and maternal and neonatal morbidity we calculated the incremental cost-effectiveness ratios, which represent the costs to prevent one of these adverse outcomes.RESULTS: Mean costs per woman in the Foley catheter group (n = 411) and in the prostaglandin E₂ gel group (n = 408), were €3297 versus €3075, respectively, with an average difference of €222 (95% confidence interval -€157 to €633). In the Foley catheter group we observed higher costs due to longer labour ward occupation and less cost related to induction material and neonatal admissions. Foley catheter induction showed a comparable caesarean section rate compared with prostaglandin induction, therefore the incremental cost-effectiveness ratio was not informative. Foley induction resulted in fewer neonatal admissions (incremental cost-effectiveness ratio €2708) and asphyxia/postpartum haemorrhage (incremental cost-effectiveness ratios €5257) compared with prostaglandin induction.CONCLUSIONS: Foley catheter and prostaglandin E2 labour induction generate comparable costs.

AB - OBJECTIVE: To assess the economic consequences of labour induction with Foley catheter compared to prostaglandin E2 gel.DESIGN: Economic evaluation alongside a randomised controlled trial.SETTING: Obstetric departments of one university and 11 teaching hospitals in the Netherlands.POPULATION: Women scheduled for labour induction with a singleton pregnancy in cephalic presentation at term, intact membranes and an unfavourable cervix; and without previous caesarean section.METHODS: Cost-effectiveness analysis from a hospital perspective.MAIN OUTCOME MEASURES: We estimated direct medical costs associated with healthcare utilisation from randomisation to 6 weeks postpartum. For caesarean section rate, and maternal and neonatal morbidity we calculated the incremental cost-effectiveness ratios, which represent the costs to prevent one of these adverse outcomes.RESULTS: Mean costs per woman in the Foley catheter group (n = 411) and in the prostaglandin E₂ gel group (n = 408), were €3297 versus €3075, respectively, with an average difference of €222 (95% confidence interval -€157 to €633). In the Foley catheter group we observed higher costs due to longer labour ward occupation and less cost related to induction material and neonatal admissions. Foley catheter induction showed a comparable caesarean section rate compared with prostaglandin induction, therefore the incremental cost-effectiveness ratio was not informative. Foley induction resulted in fewer neonatal admissions (incremental cost-effectiveness ratio €2708) and asphyxia/postpartum haemorrhage (incremental cost-effectiveness ratios €5257) compared with prostaglandin induction.CONCLUSIONS: Foley catheter and prostaglandin E2 labour induction generate comparable costs.

KW - Administration, Intravaginal

KW - Adult

KW - Catheters

KW - Cesarean Section

KW - Cost-Benefit Analysis

KW - Dinoprostone

KW - Female

KW - Humans

KW - Labor, Induced

KW - Netherlands

KW - Pregnancy

KW - Urinary Catheterization

KW - Vaginal Creams, Foams, and Jellies

U2 - 10.1111/1471-0528.12221

DO - 10.1111/1471-0528.12221

M3 - Article

C2 - 23530729

SN - 1470-0328

VL - 120

SP - 987

EP - 995

JO - BJOG - An International Journal of Obstetrics and Gynaecology

JF - BJOG - An International Journal of Obstetrics and Gynaecology

IS - 8

ER -

Cost-effectiveness of induction of labour at term with a Foley catheter compared to vaginal prostaglandin E₂ gel (PROBAAT trial)

Abstract

Keywords

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