Change search
ReferencesLink to record
Permanent link

Direct link
Reduction in resource use with the misoprostol vaginal insert vs the dinoprostone vaginal insert for labour induction: a model-based analysis from a United Kingdom healthcare perspective
Spire Bristol Hospital, England.
Spire Bristol Hospital, England.
Covance Inc, England.
Covance Inc, England.
Show others and affiliations
2016 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 16, no 1, 49- p.Article in journal (Refereed) PublishedText
Abstract [en]

Background: In view of the increasing pressure on the UKs maternity units, new methods of labour induction are required to alleviate the burden on the National Health Service, while maintaining the quality of care for women during delivery. A model was developed to evaluate the resource use associated with misoprostol vaginal inserts (MVIs) and dinoprostone vaginal inserts (DVIs) for the induction of labour at term. Methods: The one-year Markov model estimated clinical outcomes in a hypothetical cohort of 1397 pregnant women (parous and nulliparous) induced with either MVI or DVI at Southmead Hospital, Bristol, UK. Efficacy and safety data were based on published and unpublished results from a phase III, double-blind, multicentre, randomised controlled trial. Resource use was modelled using data from labour induction during antenatal admission to patient discharge from Southmead Hospital. The models sensitivity to key parameters was explored in deterministic multi-way and scenario-based analyses. Results: Over one year, the model results indicated MVI use could lead to a reduction of 10,201 h (28.9 %) in the time to vaginal delivery, and an increase of 121 % and 52 % in the proportion of women achieving vaginal delivery at 12 and 24 h, respectively, compared with DVI use. Inducing women with the MVI could lead to a 25.2 % reduction in the number of midwife shifts spent managing labour induction and 451 fewer hospital bed days. These resource utilisation reductions may equate to a potential 27.4 % increase in birthing capacity at Southmead Hospital, when using the MVI instead of the DVI. Conclusions: Resource use, in addition to clinical considerations, should be considered when making decisions about labour induction methods. Our model analysis suggests the MVI is an effective method for labour induction, and could lead to a considerable reduction in resource use compared with the DVI, thereby alleviating the increasing burden of labour induction in UK hospitals.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD , 2016. Vol. 16, no 1, 49- p.
Keyword [en]
Misoprostol; Dinoprostone; Labour induction; Resource; Vaginal insert
National Category
Obstetrics, Gynecology and Reproductive Medicine Other Medical Sciences not elsewhere specified
URN: urn:nbn:se:liu:diva-125807DOI: 10.1186/s12913-016-1278-9ISI: 000369968100002PubMedID: 26864022OAI: diva2:910322

Funding Agencies|Ferring Pharmaceuticals A/S

Available from: 2016-03-08 Created: 2016-03-04 Last updated: 2016-03-31

Open Access in DiVA

fulltext(1140 kB)21 downloads
File information
File name FULLTEXT01.pdfFile size 1140 kBChecksum SHA-512
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Andersson, F.
By organisation
Linköping University
In the same journal
BMC Health Services Research
Obstetrics, Gynecology and Reproductive MedicineOther Medical Sciences not elsewhere specified

Search outside of DiVA

GoogleGoogle Scholar
Total: 21 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 319 hits
ReferencesLink to record
Permanent link

Direct link