OBJECTIVES : Pre-eclampsia affects about 5% of pregnancies in China and the proportion of early-onset PE patients is increasing in recent years. The study aims to estimate the economic impact of introducing the soluble fms-like tyrosine kinase (sFlt-1) to placental growth factor (PlGF) ratio test into current clinical practice in guiding the management of pregnant women with suspected pre-eclampsia in China.

METHODS : An economic model is developed to compare the costs from first suspicion to birth of ‘no-test’ scenario in line with current diagnostic standards and ‘test’ scenario based on sFlt-1/ PlGF ratio test besides current standard practice. All suspected pre-eclampsia patients between 24+0 and 36+6 weeks’ gestation are assumed to be managed in three intensity management. Low-intensity managed patients have weekly outpatient visit, intermediate-intensity managed patients take twice-weekly outpatient visit, and high-intensity managed patients must be hospitalized. Clinical indicators and test characteristics are derived from Chinese data in PROGNOSIS Asia study, and resource use data are retrieved from a real-world study on the resource use in six maternity and infant hospitals in China.

RESULTS : The pre-eclampsia cost ‘no-test’ group about €1,482 per patient and it cost ‘test’ group €1,134 per patient. Compared with ‘no-test’ scenario, the inclusion of the sFlt-1/PlGF ratio test into current clinical pathway could help save €348 per patient mainly due to the avoidance of unnecessary hospitalization because of accurate rule out of suspected pre-eclampsia patients who won’t develop pre-eclampsia.

CONCLUSIONS : Introducing the sFlt-1/PlGF ratio test into Chinese clinical practice was shown to be cost-saving compared with the current diagnostic procedures.