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The European Journal of Health Economics
Published in: The European Journal of Health Economics 3/2019

Open Access 01-04-2019 | Original Paper

Cost-effectiveness of controlling gestational diabetes mellitus: a systematic review

Authors: Najmiatul Fitria, Antoinette D. I. van Asselt, Maarten J. Postma

Published in: The European Journal of Health Economics | Issue 3/2019

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Abstract

Objective

Timely screening for hyperglycaemia in pregnancy using a simple glucose test enhances early detection and control of gestational diabetes mellitus (GDM). The aim of this study was to provide an overview of the evidence on the cost-effectiveness of identification and/or treatment of GDM.

Methods

We conducted a systematic review using three electronic databases (PubMed, EMBASE, and Cochrane) of cost-effectiveness studies of GDM screening and treatment published during 2000–2017.

Results

The initial search discovered 287 references (PubMed 86, EMBASE 195, Cochrane library 6) of which six full articles were included in the review. Two articles were model-based analysis and the remaining four were trial based. Two studies demonstrated favorable cost-effectiveness of intensified management of mild GDM. In the other included studies, neither screening nor treatment of GDM was shown to be cost effective, although results varied with the particular outcome measures used and the assumptions that where applied.

Conclusion

Neither screening nor treating GDM seems to be convincingly cost-effective from the studies reviewed. However, all studies were done in high-income countries with obviously different health systems than low-/middle-income countries (LMIC) have. Since detection of GDM may be relatively poor in LMIC, screening might be more worthwhile in these countries. Comprehensive research is necessary in LMIC, including the potential outcomes of assessing its cost-effectiveness. Favorable cost-effectiveness could help in bridging the need for and access to increased diabetes screening in early pregnancy in these countries.
Appendix
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Metadata
Title
Cost-effectiveness of controlling gestational diabetes mellitus: a systematic review
Authors
Najmiatul Fitria
Antoinette D. I. van Asselt
Maarten J. Postma
Publication date
01-04-2019
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue 3/2019
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-018-1006-y

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