Cost of bacterial vaginosis in pregnancy. Decision analysis and cost evaluation of a clinical study in Germany.

OBJECTIVE To estimate the economic impact of screening for and treatment of bacterial vaginosis during early pregnancy. STUDY DESIGN Data from a clinical study that aligned two screening and treatment strategies and a no-screening or treatment strategy with three gynecologic practices in Berlin were used in decision tree analysis. Costs applied to the clinical outcomes were determined from standard German references and the charges from university clinics. RESULTS Practices A and B screened all 600 patients in the early second trimester and treated the positive cases with clindamycin 2% vaginal cream (A) or a Lactobacillus preparation (B), which incurred lower total costs, $493,159 and $497,619, as compared to practice C (total costs, $534,926), which did not screen or treat for bacterial vaginosis. Including costs of screening and treatment, the net savings of practice A as compared to practice C was estimated to be $47,316. CONCLUSION The presence of more preterm, premature and low-birth-weight infants added costs for practice C. The estimated cost savings lend support to the value of screening and treatment for bacterial vaginosis in early pregnancy.