TY - JOUR T1 -澳大利亚妊娠期抗癫痫药物注册社区效益的经济评估JF - Neurology JO - Neurology SP - e1028 LP - e1037 DO - 10.1212/WNL.0000000000201655半岛投注体育官网VL - 100 IS - 10 AU -阿德米，Zanfina AU -玛奎娜，Clara AU - Perucca, Piero AU -希区考克，Alison AU - Graham, Janet AU - Eadie, Mervyn J. AU - Liew, Danny AU - O'Brien, Terence J. AU - Vajda, Frank J. Y1 - 2023/03/07 UR - //www.ebmtp.com/cont半岛投注体育官网ent/100/10/e1028.abstract N2 -背景和目的Raoul Wallenberg澳大利亚怀孕登记册(APR)的建立是为了收集，分析，公布有关暴露于抗癫痫药物(asm)的婴儿风险的数据，并随着时间的推移促进管理护理的质量改进。这是世界各地已经建立的几个前瞻性观察性妊娠记录之一。虽然APR和其他登记处有助于知识的获取，并已应用于减少不良妊娠结局，但其成本效益仍然未知。在这里，我们旨在从社会和医疗保健系统的角度评估APR的经济影响。方法使用决策分析建模，我们估计了APR在20年时间范围内(2000-2019年)的有效性(预防不良妊娠结局)和成本(不良妊娠结局和登记本身的成本)。比较对象设定为1998年至2002年间APR收集的不良妊娠结局(即没有APR衍生的护理改善)。在情景分析中，我们保守地假设年利率对医疗保健和社会成本节省的贡献分别为2.5%和5%。不良妊娠结局包括死产、出生缺陷和人工流产。 All cost data were derived from published sources. Health and economic outcomes were extrapolated to the total target Australian epilepsy population. The primary outcomes of interest were the return of investment (ROI) for the APR and incremental cost-effectiveness ratio (ICER) for cost per adverse outcome avoided.Results Over the 20-year time horizon, the ROI from the APR from a societal perspective was Australian dollars (AUD) 2,250 (i.e., every dollar spent on the program resulted in a return of AUD2,250). Over this time, it was estimated that 9,609 adverse pregnancy outcomes were avoided, and health care and societal costs were reduced by AUD 191 million and AUD 9.0 billion, respectively. Hence, from a health economic point of view, the APR was dominant, providing cost saving ICERs from both perspectives.Discussion Following its inception 20+ years ago, the APR has represented excellent value for investment for Australia, being also health-saving and cost saving from a societal and a health care perspective. With the growing number of marketed ASMs, the APR is expected to continue to have a major impact in the foreseeable future.APR=Australian Pregnancy Register; ASM=antiseizure medication; AUD=Australian dollars; ICER=incremental cost-effectiveness ratio; ROI=return on investment; VSLY=value of a statistical life year ER -