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Screening for factor V Leiden mutation before prescribing combination oral contraceptives.
Creinin, M D; Lisman, R; Strickler, R C.
Afiliação
  • Creinin MD; Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pennsylvania 15213-3180, USA. mcreinin@mail.magee.edu
Fertil Steril ; 72(4): 646-51, 1999 Oct.
Article em En | MEDLINE | ID: mdl-10521103
OBJECTIVE: To evaluate the cost-effectiveness of screening for factor V Leiden mutation in women in the United States who use combination oral contraceptives. DESIGN: Cost-effectiveness analysis. SETTING: A national research reference laboratory, a university medical center, and an academic health center managed care organization. PATIENT(S): Women of reproductive age in the United States. INTERVENTION(S): Baseline risk estimates of venous thromboembolic disease in the general population and in carriers of factor V Leiden mutation were calculated using available data. MAIN OUTCOME MEASURE(S): The number of women who would require factor V Leiden testing and the cost of identifying this cohort to prevent one death caused by venous thromboembolic disease before prescribing combination oral contraceptives. RESULT(S): To prevent one venous thromboembolic death attributable to the use of oral contraceptives in women with factor V Leiden mutation, >92,000 carriers would need to be identified and stopped from using these pills. The estimated charge to prevent this one death would exceed $300 million. If the price of testing were discounted to 34.5% of current charges, the cost still would be between $105 million and $130 million. CONCLUSION(S): Screening for factor V Leiden mutation before prescribing combination oral contraceptives is not a cost-effective use of U.S. health care dollars. The best and most cost-effective screening tool we have is taking a thorough personal and family history related to venous thromboembolic events.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fator V / Testes Genéticos / Anticoncepcionais Orais Combinados / Mutação Tipo de estudo: Diagnostic_studies / Prognostic_studies / Screening_studies Limite: Adult / Female / Humans Idioma: En Revista: Fertil Steril Ano de publicação: 1999 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fator V / Testes Genéticos / Anticoncepcionais Orais Combinados / Mutação Tipo de estudo: Diagnostic_studies / Prognostic_studies / Screening_studies Limite: Adult / Female / Humans Idioma: En Revista: Fertil Steril Ano de publicação: 1999 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos