Acyclovir prophylaxis for pregnant women with a known history of herpes simplex virus: A cost-effectiveness analysis

Sarah E. Little, Aaron B. Caughey

Research output: Contribution to journalArticle

22 Scopus citations

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 languageEnglish (US)
Pages (from-to)1274-1279
Number of pages6
JournalAmerican journal of obstetrics and gynecology
Volume193
Issue number3 SUPPL.
DOIs
StatePublished - Sep 1 2005

Keywords

  • Acyclovir
  • Antiviral therapy
  • Cost-effectiveness analysis
  • Decision analysis
  • Neonatal herpes simplex virus infection

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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