Broad, low-dose aspirin administration to pregnant women, ideally initiated before 16 weeks of gestation, would prevent preeclampsia, preterm birth, and decrease health care costs, according to a cost-benefit analysis of low-dose aspirin prophylaxis for the prevention of preeclampsia in the US. A decision model to evaluate 4 approaches to aspirin prophylaxis in the US was created: no prophylaxis, prophylaxis per American College of Obstetricians and Gynecologists recommendations, prophylaxis per US Preventive Services Task Force recommendations, and universal prophylaxis. The study determined:

• The estimated rate of preeclampsia would be 4.18% without prophylaxis vs 4.17% with the College approach in which 0.35% (n=14,000) of women receive aspirin, 3.83% with the U.S. Preventive Services Task Force approach in which 23.5% (n=940,800) receive aspirin, and 3.81% with universal prophylaxis.

• Compared with no prophylaxis, the U.S. Preventive Services Task Force approach would save $377.4 million in direct medical care costs annually.

• The U.S. Preventive Services Task Force approach was the most cost-beneficial in 79% of probabilistic simulations.

• The universal approach was the most cost-effective in more than 99% of simulations.

Citation: Werner EF, Hauspurg AK, Rouse DJ. A cost-benefit analysis of low-dose aspirin prophylaxis for the prevention of preeclampsia in the United States. [Published online ahead of print November 5, 2015]. JAMA Oncol. doi: 10.1097/AOG.0000000000001115.