Cost of bacterial vaginosis in pregnancy - Decision analysis and cost evaluation of a clinical study in Germany

OBJECTIVE: To estimate the economic impact of screening for and treatment o f bacterial vaginosis during early pregnancy. STUDY DESIGN: Data from a clinical study that aligned two screening and tre atment strategies and it noscreening or treatment strategy with three gynec ologic practices in Berlin were used in decision tree analysis. Costs appli ed to the clinical outcomes were determined from standard German references and the charges from university clinics. RESULTS: Practices A and B screened all 600 patients in the early second tr imester and treated the positive cases with clindamycin 2% vaginal cream (A ) or a Lactobacillus preparation (B), which incurred lower total costs, $49 3,159 and $497,619, as compared to practice C (total costs, $534,926), whic h did not screen or treat for bacterial vaginosis. Including costs of scree ning and treatment, the net savings of practice A as compared to practice C was estimated to be $47,316. CONCLUSION: The presence of more preterm, premature and low-birth-weight in fants added costs for practice C. The estimated cost savings lend support t o the value of screening and treatment for bacterial vaginosis in early pre gnancy.