Name / organisation - Group B Strep Support
P4 Summary P6-8 Summary P6-8 The opportunity cost of the screening programme (including testing, diagnosis and treatment, administration, training and quality assurance) should be economically balanced in relation to expenditure on medical care as a whole (ie value for money). Assessment against this criteria should Screening will prevent more early-onset group B Strep infections than a risk-based prevention strategy Screening is more cost effective than a risk-based prevention strategy – for example, in the US by over 80% v , in Spain by 86% vi , in Australia by 82% vii and in France by 71%. viii The review only mentions the US, not the experience from other countries. 80-90% of early-onset group B Strep infection xvi could be preventable if intravenous antibiotics were offered in labour to all GBS carriers identified by universal sensitive testing late in pregnancy plus to the mothers of babies in the recognised higher risk situations. A risk factor approach on its own, assuming all risk factors trigger antibiotics in labour, can prevent only 50-60% of all cases of early-onset GBS infection. A population based study from 2002 ix found that the screening approach was more than 50% effective than the risk-based approach at preventing early-onset GBS infection. Preventing early-onset GBS infection in babies will save money compared with treating the effects. Within the last five years, four reports have been commissioned through the Government’s Health Technology Assessment Programme x xi xii xiii to establish how to combat preventable GBS infection in newborn babies. All have found screening to be more cost effective than risk-based prevention and recommended that steps to introduce screening should be explored. This research seems to have been ignored and no explanation given as to why.
have regard to evidence from cost benefit and/or cost effectiveness analyses and have regard to the effective use of available resource P65-67 Summary: Criterion 2 Partly Met P20-21 The test should be acceptable to the population P44-45 Screening identifies women most likely to be carrying GBS at delivery and allows antibiotics to be targeted to women whose babies are most at risk of early-onset GBS infection. Government focus on preventative medicine Women want to be told about group B Strep and offered GBS screening during pregnancy Using screening to identify women carrying GBS will allow antibiotics to be targeted to women who are actually most likely to be carrying GBS at delivery and whose babies are at greatest risk. Risk factors are ineffective at identifying which women are likely to be carrying GBS at delivery xii . Currently many women given antibiotics during labour based on risk factors do not require them, while others, whose babies would benefit, are ignored. With screening, fewer women who are not carrying group B Strep at delivery will be given unnecessary antibiotics xii . With the recent Government focus on preventative medicine, now is the ideal time to introduce screening for GBS in pregnancy. A survey undertaken by ComRes xiv on behalf of GBSS showed over half (54%) the women aged 20-35 surveyed had heard of group B Strep, only 20% knew what it was once aware of the dangers of group B Strep in pregnancy, over 90% of young women believe pregnant women should always be offered information, tests and, when