Yearly hypertension screening in women with a history of pre-eclampsia: a cost-effectiveness analysis
Number of pages
SourceNetherlands Heart Journal, 23, 12, (2015), pp. 585-591
Article / Letter to editor
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Netherlands Heart Journal
SubjectRadboudumc 13: Stress-related disorders DCMN: Donders Center for Medical Neuroscience; Radboudumc 15: Urological cancers RIHS: Radboud Institute for Health Sciences; Radboudumc 16: Vascular damage RIHS: Radboud Institute for Health Sciences
BACKGROUND: Women with a history of preeclampsia are at increased risk for future hypertension and cardiovascular disease (CVD); until now it is not clear whether preventive measures are needed. METHODS: A decision-analytic Markov model was constructed to evaluate healthcare costs and effects of screening and treatment (100 % compliance) for hypertension post preeclampsia based on the available literature. Cardiovascular events and CVD mortality were defined as health states. Outcomes were measured in absolute costs, events, life-years and quality-adjusted life-years (QALYs). Sensitivity and threshold analyses were performed to address uncertainty. RESULTS: Over a 20-year time horizon, events occurred in 7.2 % of the population after screening, and in 8.5 % of the population without screening. QALYs increased from 16.37 (no screening strategy) to 16.40 (screening strategy), an increment of 0.03 (95 % CI 0.01;0.05) QALYs. Total expected costs were euro 8016 in the screening strategy, and euro 9087 in the none screening strategy (expected saving of euro 1071 (95 % CI - 3146;-87) per person). CONCLUSION: Annual hypertension screening and treatment in women with a history of preeclampsia may save costs, for at least a similar quality of life and survival due to prevented CVD compared with standard care.
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