The European journal of health economics : HEPAC : health economics in prevention and care · 2026
Remote and self-monitoring for pregnant women at risk of gestational hypertensive disorders: a cost-effectiveness analysis.
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Gerits Marie-Lien, Bielen Samantha, Lanssens Dorien, Marneffe Wim, PREMOM II-consortium
Аннотация
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.
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.