Health Science Monitor

en Cost-Effectiveness analysis of ultrasound scans during pregnancy in Iran نظام‌های سلامت عمومی، سیاست‌گذاری و اقتصاد سلامت Health Policy, Management, and Economics پژوهشي Research Article Background & Aims: There is limited evidence in Iran regarding the costs, effectiveness, and cost-effectiveness ratios of ultrasound screening scenarios. The aim of this study was to address these knowledge gaps Materials & Methods: We used the cost-effectiveness analysis of one-time pregnancy ultrasound screening (OTPUS) and two-time pregnancy ultrasound screening (TTPUS) strategies from the <a name="_Hlk192060702">societal</a> perspective. We applied a Monte Carlo Simulation model including 1000 pregnant mothers and calculated each scenario's cost, effectiveness, and cost-effectiveness ratios based on 2020 data. We took the direct medical (obstetrician’s visits, ultrasound tariffs, and confirmatory tests) and non-medical costs (travel costs) into account to calculate the costs based on the bottom-up approach. Moreover, we estimated the number of detected fetal anomalies as an effectiveness factor by considering the sensitivity and specificity of the screening methods. The average and incremental cost-effectiveness ratios determine the cost-effectiveness of each screening scenario. The data on costs were extracted from the official Iranian public sector tariffs in 2020. Moreover, the epidemiological and diagnostic accuracy data were extracted from the published evidence. We applied the one-way sensitivity analysis to determine the effects of data uncertainty on the study's findings. Results: The screening costs per pregnant mother in the OTPUS and TTPUS models were $12.08 and $17.35, and the effectiveness of these approaches was 8 and 17 detected fetal anomalies per 1000 pregnant mothers, respectively. The average cost-effectiveness ratios were $1509.50 for OTPUS and $1020.35 for TTPUS. Finally, the cost of diagnosing an additional anomaly in the two-time ultrasound approach was $585.56. Conclusion: The OTPUS model imposes 43.6% lower costs on pregnant mothers, but also detects a significantly lower number of fetal anomalies. TTPUS policy needs $585.56 more to find an extra case. Congenital Abnormalities, Cost-effectiveness, Iran, Pregnancy, Ultrasound 112 121 http://hsm.umsu.ac.ir/browse.php?a_code=A-10-319-1&slc_lang=en&sid=1 Sima Ahmadpoor simaahmadpoor@yahoo.com 10031947532846003670 0009-0005-3285-1007 No Department of Health Management and Economics, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran Hamidreza Farrokh-Eslamlou hamidfarrokh@gmail.com 10031947532846003671 10031947532846003671 No Reproductive Health Research Centre, School of Public Health, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran Hasan Yusefzadeh hyusefzade2010@gmail.com 10031947532846003672 10031947532846003672 No Department of Health Management and Economics, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran Cyrus Alinia siros_alinia@gmail.com 10031947532846003673 10031947532846003673 Yes Department of Health Management and Economics, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran