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Healthcare Policy/Economics

Poster Session 4

(1136) The Cost-Effectiveness of Access to Termination for Pregnancies Affected by Trisomy 13

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: We aimed to evaluate the cost of restrictive abortion bans in pregnancies diagnosed with fetal trisomy 13 in the first trimester.  A secondary aim was to compare costs between access to termination versus restrictive abortion ban in pregnancies affected by trisomy 13.

Study Design: Using a decision analytic model, we assessed the cost-effectiveness of two strategies for managing pregnancy with trisomy 13 diagnosed in the first trimester: legal access to pregnancy termination versus restrictive abortion ban.  Costs included were abortion procedures, travel, abortion complications, pregnancy complications, and medical care of the infant including palliative care. Effects included decision to terminate pregnancy, stillbirth, and maternal preeclampsia. The costs and effects of the two strategies were compared with the primary outcome being the cost per stillbirth averted and sensitivity analysis conducted. Variables were abstracted from published literature and the analysis was conducted from the healthcare perspective.

Results: In the base case, access to termination was less costly ($20,2016 vs $63,103) and resulted in fewer stillbirths than restricted abortion access and was, therefore, the choice strategy. The model was most sensitive to the cost of stillbirth and the probability of live birth but there were no thresholds identified in any of the variables where the choice strategy would change. Assuming current Trisomy 13 prevalence and national birthrates, access to termination would result in 222 fewer stillbirths annually and $9,520,914 lower costs.

Conclusion: For pregnancies diagnosed with fetal trisomy 13 in the first trimester, access to termination results in fewer stillbirths and reduced costs.