COST-EFFECTIVENESS OF LOW-DOSE ASPIRIN IN PREVENTING PREECLAMPSIA RELATED MATERNAL DEATHS WITHIN EXISTING HEALTH PROGRAMS
Author(s)
Sak Moinudeen, MPH, BDS1, Kavita Kachroo, MBA, MHA, Other1, Manasa Kasoj II, Other2, Aaryaman Y. Raj, BSc, MSc3, Jitendra Sharma, PHD1;
1Kalam Institute of Health Technology ( KIHT), Visakhapatnam, India, 2Kalam Institute of Health Technology ( KIHT), Mahbubnagar, India, 3Kalam Institute of Health Technology ( KIHT), Data Analyst, Visakhapatnam, India
1Kalam Institute of Health Technology ( KIHT), Visakhapatnam, India, 2Kalam Institute of Health Technology ( KIHT), Mahbubnagar, India, 3Kalam Institute of Health Technology ( KIHT), Data Analyst, Visakhapatnam, India
OBJECTIVES: Although low-dose aspirin (LDA) is clinically proven to reduce the risk of preeclampsia among high-risk pregnant women, its large-scale implementation remains limited due to lack of India-specific economic evidence. This study aimed to evaluate the cost-effectiveness of LDA compared with standard antenatal care in preventing preeclampsia-related maternal deaths within existing public health programs in India.
METHODS: A decision-analytic model was developed to compare LDA prophylaxis (75-150 mg initiated before 20 weeks of gestation) with standard of care (SoC) among pregnant women identified as high risk using the Fetal Medicine Foundation screening approach. The analysis was conducted from a societal perspective over a time horizon extending from the first trimester to six weeks postpartum. Costs included direct medical, direct non-medical, and indirect costs, expressed in 2024 Indian Rupees (INR). Health outcomes were measured in quality-adjusted life years (QALYs). Incremental cost-effectiveness ratios (ICERs) and net monetary benefit (NMB) were estimated using a willingness-to-pay threshold of ₹2,31,784 per QALY. Deterministic and probabilistic sensitivity analyses were performed to assess robustness.
RESULTS: In the base-case analysis, LDA resulted in lower mean costs (₹30,735) compared to SoC (₹30,858), yielding a cost saving of ₹123 per patient. LDA generated higher health benefits, with 46.0661 QALYs versus 46.0385 QALYs for SoC, corresponding to an incremental gain of 0.028 QALYs. The ICER was -₹4,477 per QALY gained, indicating that LDA was a dominant strategy. The incremental net monetary benefit was ₹6,525 in favor of LDA. Probabilistic sensitivity analysis showed that most simulations favored LDA as both cost-saving and more effective, with a high probability of cost-effectiveness across wide range of willingness-to-pay thresholds.
CONCLUSIONS: Low-dose aspirin is a cost-effective and cost-saving intervention for preventing preeclampsia-related maternal deaths among high-risk pregnancies in India. Integrating LDA into routine antenatal care within existing public health programs could substantially improve maternal outcomes while optimizing healthcare resource allocation.
METHODS: A decision-analytic model was developed to compare LDA prophylaxis (75-150 mg initiated before 20 weeks of gestation) with standard of care (SoC) among pregnant women identified as high risk using the Fetal Medicine Foundation screening approach. The analysis was conducted from a societal perspective over a time horizon extending from the first trimester to six weeks postpartum. Costs included direct medical, direct non-medical, and indirect costs, expressed in 2024 Indian Rupees (INR). Health outcomes were measured in quality-adjusted life years (QALYs). Incremental cost-effectiveness ratios (ICERs) and net monetary benefit (NMB) were estimated using a willingness-to-pay threshold of ₹2,31,784 per QALY. Deterministic and probabilistic sensitivity analyses were performed to assess robustness.
RESULTS: In the base-case analysis, LDA resulted in lower mean costs (₹30,735) compared to SoC (₹30,858), yielding a cost saving of ₹123 per patient. LDA generated higher health benefits, with 46.0661 QALYs versus 46.0385 QALYs for SoC, corresponding to an incremental gain of 0.028 QALYs. The ICER was -₹4,477 per QALY gained, indicating that LDA was a dominant strategy. The incremental net monetary benefit was ₹6,525 in favor of LDA. Probabilistic sensitivity analysis showed that most simulations favored LDA as both cost-saving and more effective, with a high probability of cost-effectiveness across wide range of willingness-to-pay thresholds.
CONCLUSIONS: Low-dose aspirin is a cost-effective and cost-saving intervention for preventing preeclampsia-related maternal deaths among high-risk pregnancies in India. Integrating LDA into routine antenatal care within existing public health programs could substantially improve maternal outcomes while optimizing healthcare resource allocation.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE72
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Reproductive & Sexual Health