Hae Young Lee1, Seung Won Lee2,3, Hyeon Chang Kim2,3, Sang Hyun Ihm4, Sung Ha Park5, Tae Hyun Kim6. 1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. 2. Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea. 3. Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea. 4. Division of Cardiology, College of Medicine, Catholic University of Korea, Seoul, Korea. 5. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. 6. Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, Korea. THKIM@yuhs.ac.
Abstract
BACKGROUND AND OBJECTIVES: To evaluate the cost-effectiveness of routine hypertension (HTN) screening as a part of the national health-screening program. METHODS: Two aspects of cost-effectiveness were examined using the national general health-screening program. First, the cost of case-finding was computed for 5-year interval age groups. Second, the cost per quality adjusted life years (QALYs) gained were estimated for 12 different scenarios varying examination starting age, pattern and interval compared with no screening. RESULTS: The cost of finding one new HTN case was low as 26,284 Korean won (KRW) (approximately [approx.] United States Dollar 21) for 70-79 years old to as high as 70,552 KRW for 40-44 years old. Compared with no screening, the costs per QALYs of the following screening strategies were below the incremental cost-effectiveness ratio threshold (approx. KRW 30.5 million): first screening examination with the second confirmatory examination in adults aged ≥40 years every 3 years (KRW 10.2 million), every 2 years (KRW 13.2 million), or annually (KRW 19.9 million). One-way sensitivity analyses suggest that the results were mostly influenced by the sensitivity of the first screening examination, followed by the examination rate of the second confirmatory examination. CONCLUSIONS: HTN screening as a part of routine national health screening program was cost-effective for adults aged 40 years or older. The most cost-effective HTN screening strategy was the first screening examination with the second confirmatory examination in aged 40 years or older every 3 years.
BACKGROUND AND OBJECTIVES: To evaluate the cost-effectiveness of routine hypertension (HTN) screening as a part of the national health-screening program. METHODS: Two aspects of cost-effectiveness were examined using the national general health-screening program. First, the cost of case-finding was computed for 5-year interval age groups. Second, the cost per quality adjusted life years (QALYs) gained were estimated for 12 different scenarios varying examination starting age, pattern and interval compared with no screening. RESULTS: The cost of finding one new HTN case was low as 26,284 Korean won (KRW) (approximately [approx.] United States Dollar 21) for 70-79 years old to as high as 70,552 KRW for 40-44 years old. Compared with no screening, the costs per QALYs of the following screening strategies were below the incremental cost-effectiveness ratio threshold (approx. KRW 30.5 million): first screening examination with the second confirmatory examination in adults aged ≥40 years every 3 years (KRW 10.2 million), every 2 years (KRW 13.2 million), or annually (KRW 19.9 million). One-way sensitivity analyses suggest that the results were mostly influenced by the sensitivity of the first screening examination, followed by the examination rate of the second confirmatory examination. CONCLUSIONS: HTN screening as a part of routine national health screening program was cost-effective for adults aged 40 years or older. The most cost-effective HTN screening strategy was the first screening examination with the second confirmatory examination in aged 40 years or older every 3 years.