Abstract
Objective: Previous literature has shown acyclovir to be cost-effective as prophylaxis for women with genital symptomatic herpes simplex virus infection recurrence during pregnancy. We extend this analysis by adding quality-adjusted life year measurements and considering women with a diagnosed history of herpes simplex virus infection but without recurrence in pregnancy. Study design: A decision analytic model was designed that compared acyclovir prophylaxis versus no acyclovir for women with a history of diagnosed genital herpes simplex virus infection but without recurrence in pregnancy. Sensitivity analysis and Monte Carlo simulations were performed to test for robustness. Results: We found that 22,286 women must be treated to prevent 1 neonatal death, 8985 women to prevent 1 affected child, and 177 women to prevent 1 cesarean delivery. As compared with no acyclovir, acyclovir prophylaxis at 36 weeks of gestation saves approximately $20 per person and increases total quality-adjusted life years by 0.01. In univariate sensitivity analysis, this result was robust to all reasonable probability and quality-adjusted life year estimates. Monte Carlo simulation demonstrated acyclovir to be cost-effective 100% of the time and cost saving >99% of the time. Conclusion: Acyclovir prophylaxis versus no treatment for pregnant women with a diagnosed history of genital herpes simplex virus infection but without recurrence during pregnancy is cost-effective over a wide range of assumptions.
Original language | English (US) |
---|---|
Pages (from-to) | 1274-1279 |
Number of pages | 6 |
Journal | American journal of obstetrics and gynecology |
Volume | 193 |
Issue number | 3 SUPPL. |
DOIs | |
State | Published - Sep 2005 |
Externally published | Yes |
Keywords
- Acyclovir
- Antiviral therapy
- Cost-effectiveness analysis
- Decision analysis
- Neonatal herpes simplex virus infection
ASJC Scopus subject areas
- Obstetrics and Gynecology