Vaginal Progesterone – Cost and Health Care Utilization for Preventing Preterm Births in the United States [19K]

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 129 Suppl 1; no. 1; p. 116S
• Main Authors: Eke, Ahizechukwu C, Onasanya, Oluwadamilola, Johnson, Clark T
• Format: Journal Article
• Language: English
• Published: by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved 01.05.2017
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/01.AOG.0000514612.45386.e9

INTRODUCTION:To examine the cost and healthcare utilization patterns of vaginal progesterone for the prevention of preterm-births in women with singleton gestations and a sonographic short cervix in the United States. METHODS:Using a nationwide database (MarketScan) of patientsʼ de-identified healthcare and medication utilization, we assessed vaginal progesterone use and preterm-birth associated health care spending from January 2010 through December 2014. We compared the utilization rates across regions, states and age groups to estimate indirect benefits. We estimated national reductions in the number of preterm births, and preterm-birth associated costs. RESULTS:By December 31, 2014, the national utilization rate of vaginal progesterone was 62.5% in the Midwest, 63.6% in the Northeast, and 62.4% in the southwest. Relative reductions in preterm birth were 33% in 2012–2013 (95% CI, 29 to 37) and by 25% in 2013–2014 (95% CI, 23 to 27). Rates of hospitalization for preterm labor in 2010–2012, 2012–2013, and 2013–2014 were 24, 18, and 12 cases per 10,000 person-years with corresponding relative reductions of 52% in 2010-2012 (95% CI, 48 to 57) and 58% (95% CI, 47 to 59) in 2013–2014. Utilization rates was highest for Prometrium [78% (95% CI, 71 to 84)], Crinone [56% (95% CI, 51 to 63)] and Endometrin [28% (95% CI, 23 to 34)]. Nationally, for the 2010–2014 period, there was an estimated reduction of 65,250 hospitalizations for preterm births, saving approximately $113 million in treatment costs. CONCLUSION:Since the introduction of vaginal progesterone, preterm birth associated health care utilization and medical expenditures for U.S. hospitals have decreased substantially.