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Cost‐effectiveness analysis of screening for primary aldosteronism in China
Author(s) -
Li Na,
Huang Jingze,
Zheng Bin,
Cai Hongfu,
Liu Maobai,
Liu Libin
Publication year - 2021
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.14478
Subject(s) - medicine , primary aldosteronism , blood pressure , cost effectiveness , cost effectiveness analysis , quality adjusted life year , pediatrics , intensive care medicine , risk analysis (engineering)
Objective Primary aldosteronism (PA) is an underdiagnosed cause of hypertension. Although the medical costs will increase if all patients with elevated blood pressure are screened, the number of missed diagnosed patients with PA and the medical resources subsequently consumed by adverse cardiovascular and cerebrovascular events can be reduced. This study aimed to conduct economic evaluation PA screening strategies in Chinese patients with hypertension, that is PA screening in patients with high‐risk hypertension and all patients with hypertension, to determine the cost‐effective method. Methods The decision tree and Markov model were constructed using TreeAge Pro 2020. Using the latter, a 30‐year course of hypertension after different screening strategies was simulated, with a cycle of one year. The model parameters included epidemiological data, clinical efficacy, cost and effectiveness. The total cost of treatment and quality‐adjusted life year (QALY) were simulated to conduct a cost‐effectiveness analysis. Univariate and probabilistic sensitivity analyses of the model were also performed. Results PA screening patients with high‐risk hypertension and all patients with hypertension obtained 15.75 and 15.77 QALYs and the costs were $2488.39 and $2482.15, respectively. The strategy of PA screening in all patients with hypertension is cost‐saving and produces more health outcomes. The sensitivity analysis showed that the results were reliable. Conclusion From the perspective of China's health system, the strategy of screening all hypertensive patients for PA may be more cost‐effective than screening only high‐risk patients and providing standard antihypertensive treatment for low‐risk hypertensive patients.