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

Research output: Contribution to journalArticle

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

ASJC Scopus subject areas

  • Internal Medicine
  • Obstetrics and Gynaecology

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