Presentation (CTI)

OBJECTIVES: Perinatal depression is highly prevalent among Chinese women, but universal screening strategies requires substantial investment. This study aims to develop a targeted screening strategy and to estimate its’ cost-effectiveness and budget.
METHODS: Based on trajectory of depressive symptom scores, high-risk women were identified by three factors: anxiety symptoms, lower social support levels and severe depressive symptoms (PHQ-9>14). The screening strategy involved one screening during the first, second and third trimester and one within 42 days postpartum, combined with group psychological counseling for those who screened positive. Adopting a payer’s perspective, the cost-effectiveness and affordability of the targeted screening strategy were evaluated against both no screening and universal screening strategies with a Markov decision analysis model, which simulated a cohort of 100,000 Chinese pregnant women from the first trimester to one year postpartum.
RESULTS: Compared with no screening (cost: 0.00 CNY/person; healthy life-year: 1.8006 life years /person), both targeted screening (87.92 CNY/person; 1.8025 life years/person) and universal screening(629.06 CNY/person; 1.8147 life years/person) incurred higher costs but both saved more healthy life years. The targeted screening strategy costed 46,273.68 CNY per healthy life year saved, while the universal screening strategy costed 44,614.18 CNY per healthy life year saved. Using China's 3 times per capita gross domestic product (GDP) in 2024 as the willingness-to-pay threshold (287,247.00 CNY), both screening strategies were cost-effective. Compared with universal screening strategy, the targeted screening strategy costed 44,355.74 CNY per healthy life year saved. When the probability of affordability reached 100%, the budget for the targeted screening strategy amounted to 16.84 million CNY, while the budget for the universal screening strategy was 120.00 million CNY.
CONCLUSIONS: Compared with no screening, both targeted and universal screening strategies demonstrate cost-effectiveness advantages. In resource-limited areas, the targeted screening strategy should be prioritized.