Remote and self-monitoring for pregnant women at risk of gestational hypertensive disorders: a cost-effectiveness analysis.

IF 3.1 3区医学 Q1 ECONOMICS

European Journal of Health Economics Pub Date : 2026-09-30 DOI:10.1007/s10198-026-01995-4

Marie-Lien Gerits, Samantha Bielen, Dorien Lanssens, Wim Marneffe

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引用次数: 0

Abstract

Objectives: Gestational hypertensive disorders (GHD) are common pregnancy-related disorders associated with adverse outcomes. Adequate blood pressure monitoring is essential to mitigate these risks. Remote monitoring (RM) and patient self-monitoring (PSM) may provide alternatives to conventional care. However, their cost-effectiveness remains unassessed. This study evaluated the cost-effectiveness of RM and PSM compared with conventional care for pregnant women at risk of GHD.

Methods: This trial-based economic evaluation used PREMOM II trial data and InterMutualistic Agency cost data. A cost-utility analysis was conducted from a healthcare payer perspective, with results expressed as costs per quality-adjusted life year (QALY) gained. Uncertainty was assessed through one-way and probabilistic sensitivity analyses.

Results: At the mother-infant dyad level, RM and PSM generated small QALY gains versus conventional care (0.001 and 0.004 QALYs) and higher costs (€337.91 and €898.45). ICERs were €304,046/QALY for RM and €222,483/QALY for PSM, both exceeding the NICE willingness-to-pay reference range of £25,000-£35,000/QALY. In the full incremental analysis, RM was extendedly dominated by PSM. Probabilistic sensitivity analysis showed substantial uncertainty across comparisons.

Conclusions: There is insufficient evidence to determine the relative cost-effectiveness of RM or PSM compared with conventional care. Consequently, the analysis provides no evidence to justify reimbursement.

Trial registration: The study is registered with ClinicalTrials.gov NCT04031430 on November 11, 2018.

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妊娠期高血压疾病风险孕妇的远程和自我监测：成本-效果分析

目的：妊娠期高血压疾病（GHD）是常见的妊娠相关疾病，与不良结局相关。适当的血压监测对减轻这些风险至关重要。远程监测（RM）和患者自我监测（PSM）可能提供替代传统护理。然而，它们的成本效益仍未得到评估。本研究评估了与传统护理相比，RM和PSM对有GHD风险的孕妇的成本-效果。方法：本试验经济评价采用PREMOM II试验数据和InterMutualistic Agency成本数据。从医疗保健付款人的角度进行了成本效用分析，结果表示为每个质量调整生命年（QALY）获得的成本。通过单向和概率敏感性分析评估不确定性。结果：在母婴水平上，与传统护理相比，RM和PSM产生了较小的QALY收益（0.001和0.004 QALY），成本更高（337.91欧元和898.45欧元）。RM的ICERs为304,046欧元/QALY， PSM的ICERs为222,483欧元/QALY，两者都超过了NICE的支付意愿参考范围25,000- 35,000英镑/QALY。在全增量分析中，RM扩展为PSM主导。概率敏感性分析显示，在比较中存在很大的不确定性。结论：没有足够的证据来确定RM或PSM与传统护理相比的相对成本效益。因此，分析没有提供证明偿还的证据。试验注册：该研究已于2018年11月11日在ClinicalTrials.gov注册NCT04031430。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Health Economics Multiple-

CiteScore

6.10

自引率

2.30%

发文量

131

期刊介绍： The European Journal of Health Economics is a journal of Health Economics and associated disciplines. The growing demand for health economics and the introduction of new guidelines in various European countries were the motivation to generate a highly scientific and at the same time practice oriented journal considering the requirements of various health care systems in Europe. The international scientific board of opinion leaders guarantees high-quality, peer-reviewed publications as well as articles for pragmatic approaches in the field of health economics. We intend to cover all aspects of health economics: • Basics of health economic approaches and methods • Pharmacoeconomics • Health Care Systems • Pricing and Reimbursement Systems • Quality-of-Life-Studies The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfill the above-mentioned requirements. Officially cited as: Eur J Health Econ