OBJECTIVES: Preeclampsia (PE) is a pregnancy disease characterized by the combined presence of hypertension and proteinuria. It represents one of the major causes of maternal and perinatal mortality and a more accurate prediction of PE risk is perceived as an impelling necessity, in order to pursue better patient management with subsequent economic and health benefits. Hence, the purpose of this analysis is to estimate the economic impact of the introduction of the soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) - ratio test for the prediction of PE, in addition to standard practice, for women with suspected preeclampsia in the Italian National Health Service (INHS). METHODS: A decision tree model has been developed to simulate the progression of a cohort of pregnant women from the first presentation of suspicion of PE in the 2nd and 3rd trimester until delivery. The model estimates the economic impact of the sFlt-1/PlGF ratio test’s adoption in comparison with standard practice thanks to the use of direct medical costs. Clinical inputs, validated by National Clinical Experts, have been obtained from the PROGNOSIS study and from a literature review process. The resources and unit costs have been gathered from Italian-specific sources. RESULTS: For a pregnant woman with clinical suspicion of PE, the adoption of sFlt-1-PlGF ratio test has produced an overall reduction in cost of €670.51, from €2,384.49 for standard clinical assessment to €1,713.98 when adding the sFlt-1/PlGF immunoassay. The potential saving for the entire cohort has amounted to €33,160,077. CONCLUSIONS: The introduction of the sFlt-1/PlGF ratio test into hospital practice has emerged as a valid cost saving alternative to the standard practice. Savings are generated primarily through an improvement in diagnostic accuracy and a reduction in unnecessary hospitalization for women before PE’s onset.