• G J van Baaren, M Jozwiak, B C Opmeer, K Oude Rengerink, M Benthem, M G K Dijksterhuis, M E van Huizen, P C M van der Salm, N W E Schuitemaker, D N M Papatsonis, D A M Perquin, M Porath, J A M van der Post, R J P Rijnders, H C J Scheepers, M Spaanderman, M G van Pampus, J W de Leeuw, B W J Mol, and K W M Bloemenkamp.
• Department of Obstetrics, Academic Medical Centre, Amsterdam, the Netherlands. g.j.vanbaaren@amc.uva.nl
• BJOG. 2013 Jul 1; 120 (8): 987-95.

ObjectiveTo assess the economic consequences of labour induction with Foley catheter compared to prostaglandin E2 gel.DesignEconomic evaluation alongside a randomised controlled trial.SettingObstetric departments of one university and 11 teaching hospitals in the Netherlands.PopulationWomen scheduled for labour induction with a singleton pregnancy in cephalic presentation at term, intact membranes and an unfavourable cervix; and without previous caesarean section.MethodsCost-effectiveness analysis from a hospital perspective.Main Outcome MeasuresWe estimated direct medical costs associated with healthcare utilisation from randomisation to 6 weeks postpartum. For caesarean section rate, and maternal and neonatal morbidity we calculated the incremental cost-effectiveness ratios, which represent the costs to prevent one of these adverse outcomes.ResultsMean costs per woman in the Foley catheter group (n = 411) and in the prostaglandin E₂ gel group (n = 408), were €3297 versus €3075, respectively, with an average difference of €222 (95% confidence interval -€157 to €633). In the Foley catheter group we observed higher costs due to longer labour ward occupation and less cost related to induction material and neonatal admissions. Foley catheter induction showed a comparable caesarean section rate compared with prostaglandin induction, therefore the incremental cost-effectiveness ratio was not informative. Foley induction resulted in fewer neonatal admissions (incremental cost-effectiveness ratio €2708) and asphyxia/postpartum haemorrhage (incremental cost-effectiveness ratios €5257) compared with prostaglandin induction.ConclusionsFoley catheter and prostaglandin E2 labour induction generate comparable costs.© 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.

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