Cost-effectiveness analysis of cardiovascular risk factor screening in women who experienced hypertensive pregnancy disorders at term

Gert Jan Van Baaren*, Wietske Hermes, Arie Franx, Maria G. Van Pampus, Kitty W.M. Bloemenkamp, Joris A. Van Der Post, Martina Porath, Gabrielle A.E. Ponjee, Jouke T. Tamsma, Ben Willem J. Mol, Brent C. Opmeer, Christianne J.M. De Groot

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Objectives To assess the cost-effectiveness of post-partum screening on cardiovascular risk factors and subsequent treatment in women with a history of gestational hypertension or pre-eclampsia at term.

Study design Two separate Markov models evaluated the cost-effectiveness analysis of hypertension (HT) screening and screening on metabolic syndrome (MetS), respectively, as compared to current practice in women with a history of term hypertensive pregnancy disorders. Analyses were performed from the Dutch health care perspective, using a lifetime horizon. One-way sensitivity analyses and Monte Carlo simulation evaluated the robustness of the results.

Results Both screening on HT and MetS in women with a history of gestational hypertension or pre-eclampsia resulted in increase in life expectancy (HT screening 0.23 year (95% CI -0.06 to 0.54); MetS screening 0.14 years (95% CI -0.16 to 0.45)). The gain in QALYs was limited, with HT screening and MetS screening generating 0.04 QALYs (95% CI -0.12 to 0.20) and 0.03 QALYs (95% CI -0.14 to 0.19), resulting in costs to gain one QALY of €4228 and €28,148, respectively. Analyses for uncertainty showed a chance of 74% and 75%, respectively, that post-partum screening is cost-effective at a threshold of €60,000/QALY.

Conclusions According to the available knowledge post-partum screening on cardiovascular risk factors and subsequent treatment in women with a history of gestational hypertension or pre-eclampsia at term is likely to be cost-effective.

Original languageEnglish
Pages (from-to)264-270
Number of pages7
JournalPregnancy Hypertension
Volume4
Issue number4
DOIs
Publication statusPublished - 1 Oct 2014

Keywords

  • Cardiovascular risk
  • Cost-effectiveness
  • Gestational hypertension
  • Pre-eclampsia
  • Pregnancy

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