Awareness of fetal movements and care package to reduce fetal mortality (AFFIRM): a trial-based and model-based cost-effectiveness analysis from a stepped wedge, cluster-randomised trial

Table 2 Direct and secondary costs associated with the AFFIRM intervention

	Cost per 1000 births
	Pre-AFFIRM	Post-AFFIRM	Difference ^e
Direct intervention costs
Training	£0	£367	£367
Leaflets	£0	£460	£460
RFM attendances ^a	£35,627	£85,511	£49,884
Inductions of labour	£282,599	£327,012	£44,413
Total ^c	£318,225	£413,351	£95,126
Secondary costs
NICU admissions > 48 h ^b	£63,454	£69,246		£5,792
Intrapartum costs ^c	£2,733,000	£2,810,000		£77,000
Stillbirth costs (per 1,000 births) ^d	£4,765	£4,396		£- 369

^a Pre-AFFIRM RFM attendances (n = 261/1000 births) and post-AFFIRM attendances (n = 495/1000 births) are from audit data from 11 study sites. Audit data also showed that the proportion of RFM attendances which resulted in an additional ultrasound scan was 30% pre-AFFIRM and 59% post-AFFIRM
^b Unit cost for NICU admissions multiplied by observed admission rate for each period (pre-AFFIRM 50.9/1000 births; post-AFFIRM 55.5/1000 births)
^c Intrapartum costs do not include the cost for inductions of labour. Only the cost of Caesarean section or vaginal birth are included here
^d Unit cost for stillbirths multiplied by observed stillbirth rate for each period (pre-AFFIRM 4.38/1,000 births; post-AFFIRM 4.04/1,000 births)
^e Values reported in the table are rounded to nearest whole £

ISSN: 1471-2393