TY - JOUR
T1 - Cost-effectiveness analysis of cardiovascular risk factor screening in women who experienced hypertensive pregnancy disorders at term
AU - Van Baaren, Gert Jan
AU - Hermes, Wietske
AU - Franx, Arie
AU - Van Pampus, Maria G.
AU - Bloemenkamp, Kitty W.M.
AU - Van Der Post, Joris A.
AU - Porath, Martina
AU - Ponjee, Gabrielle A.E.
AU - Tamsma, Jouke T.
AU - Mol, Ben Willem J.
AU - Opmeer, Brent C.
AU - De Groot, Christianne J.M.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - 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.
AB - 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.
KW - Cardiovascular risk
KW - Cost-effectiveness
KW - Gestational hypertension
KW - Pre-eclampsia
KW - Pregnancy
UR - http://www.scopus.com/inward/record.url?scp=84916930451&partnerID=8YFLogxK
U2 - 10.1016/j.preghy.2014.06.002
DO - 10.1016/j.preghy.2014.06.002
M3 - Article
AN - SCOPUS:84916930451
SN - 2210-7789
VL - 4
SP - 264
EP - 270
JO - Pregnancy Hypertension
JF - Pregnancy Hypertension
IS - 4
ER -
