Key result
Annual hypertension screening in women with a history of early pre-eclampsia increased quality-adjusted life-years by 0.03 and saved €1071 per person over 20 years compared to standard care.
Why the study?
Does annual hypertension screening reduce cardiovascular events and healthcare costs in women with a history of early preeclampsia?
Does annual hypertension screening reduce cardiovascular events and healthcare costs in women with a history of early preeclampsia?
Annual hypertension screening in women with a history of early preeclampsia is highly likely to be cost-effective, yielding small QALY gains and cost savings over 20 years.
May support modeled cost savings from annual post-preeclampsia hypertension screening; leaves open prospective validation before clinical adoption.
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 € 8016 in the screening strategy, and € 9087 in the none screening strategy (expected saving of € 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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Drost et al. (2015) studied History of early-onset preeclampsia (n=339). Annual hypertension screening and treatment vs. No screening strategy (standard care) was evaluated on Quality-adjusted life-years (QALYs) over 20 years (MD 0.03, 95% CI 0.01-0.05). Annual hypertension screening in women with a history of early pre-eclampsia increased quality-adjusted life-years by 0.03 and saved €1071 per person over 20 years compared to standard care.
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