Prof Tracy Roberts described economic evaluation not as absolute costs and benefits, but comparing new treatments to current practice.
Prof Roberts said that a mother might be positive or negative, but what was then important was whether the interventions consequent upon the result prevented the baby from getting an infection. She discussed looked at modelling three different strategies: using risk factors to determine which women to offer antibiotics in labour to, using the ‘culture test’ at 35 weeks to do this, and giving routine antibiotics to all.
“we need to understand what current practice is because it affects the comparator we put in our models – cost per QALY is probably really impossible without some severe assumptions. We need to establish better estimates for costs associated with the disease, rapid tests need to be cheap, sensitive and produce results before delivery and we need to explore alternatives to intrapartum antibiotics and we need to use a model”