澳大利亚妊娠登记抗癫痫药物社区效益的经济评价[j] Neurology JO Neurology FD Lippincott Williams & Wilkins SP e1028 OP e1037 DO 10.1212/WNL.0000000000201655半岛投注体育官网VO 100 IS 10 A1 Ademi, Zanfina A1 Marquina, Clara A1 Perucca, Piero A1 Hitchcock, Alison A1 Graham, Janet A1 Eadie, Mervyn J. A1 Liew, Danny A1 O'Brien, Terence J. A1 Vajda, Frank J. YR 2023 UL http://n.半岛投注体育官网neurology.org/content/100/10/e1028.abstract AB背景与目的建立Raoul Wallenberg Australian Pregnancy Register (APR)，收集，分析，并公布暴露于抗癫痫药物(asm)的婴儿的风险数据，并促进管理护理的质量随着时间的推移而提高。它是世界各地已建立的几个前瞻性观察性妊娠登记之一。尽管APR和其他登记处有助于减少不良妊娠结局的知识获取，但其成本效益仍不清楚。在这里，我们旨在从社会和卫生保健系统的角度评估APR的经济影响。方法使用决策分析模型，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(不良妊娠结局的成本和登记本身)。比较指标设置为1998年至2002年期间APR收集的不良妊娠结局(即没有APR获得护理改善)。在情景分析中，我们保守地假设APR对医疗保健和社会成本节约的贡献分别为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