{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T06:31:34Z","timestamp":1767853894680,"version":"3.49.0"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,1,30]],"date-time":"2020-01-30T00:00:00Z","timestamp":1580342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["HTA 12\/167\/26"],"award-info":[{"award-number":["HTA 12\/167\/26"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003921","name":"Department of Health, Australian Government","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the cost\u2010effectiveness of progesterone compared with placebo in preventing pregnancy loss in women with early pregnancy vaginal bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Economic evaluation alongside a large multi\u2010centre randomised placebo\u2010controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Forty\u2010eight UK NHS early pregnancy units.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Four thousand one hundred and fifty\u2010three women aged 16\u201339\u00a0years with bleeding in early pregnancy and ultrasound evidence of an intrauterine sac.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An incremental cost\u2010effectiveness analysis was performed from National Health Service (NHS) and NHS and Personal Social Services perspectives. Subgroup analyses were carried out on women with one or more and three or more previous miscarriages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Cost per additional live birth at \u226534\u00a0weeks of gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Progesterone intervention led to an effect difference of 0.022 (95% CI \u22120.004 to 0.050) in the trial. The mean cost per woman in the progesterone group was \u00a376 (95% CI \u2212\u00a3559 to \u00a3711) more than the mean cost in the placebo group. The incremental cost\u2010effectiveness ratio for progesterone compared with placebo was \u00a33305 per additional live birth<jats:italic>.<\/jats:italic> For women with at least one previous miscarriage, progesterone was more effective than placebo with an effect difference of 0.055 (95% CI 0.014\u20130.096) and this was associated with a cost saving of \u00a3322 (95% CI \u2212\u00a31318 to \u00a3673).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results suggest that progesterone is associated with a small positive impact and a small additional cost. Both subgroup analyses were more\u00a0favourable, especially for women who had one or more previous miscarriages. Given available evidence, progesterone is likely to be a cost\u2010effective intervention, particularly for women with previous miscarriage(s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Progesterone treatment is likely to be cost\u2010effective in women with early pregnancy bleeding and a history of miscarriage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16068","type":"journal-article","created":{"date-parts":[[2020,1,31]],"date-time":"2020-01-31T01:02:50Z","timestamp":1580432570000},"page":"757-767","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The cost\u2010effectiveness of progesterone in preventing miscarriages in women with early pregnancy bleeding: an economic evaluation based on the PRISM trial"],"prefix":"10.1111","volume":"127","author":[{"given":"CB","family":"Okeke Ogwulu","sequence":"first","affiliation":[{"name":"Health Economics Unit College of Medical and Dental Sciences Institute of Applied Health Research University of Birmingham Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I","family":"Goranitis","sequence":"additional","affiliation":[{"name":"Health Economics Unit College of Medical and Dental Sciences Institute of Applied Health Research University of Birmingham Birmingham UK"},{"name":"Health Economics Unit Centre for Health Policy Melbourne School of Population and Global Health The University of Melbourne Melbourne Vic. 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