title: Cost-effectiveness of renal denervation therapy for the treatment of resistant hypertension in The Netherlands.
abstract: OBJECTIVE
  Safety and efficacy data for catheter-based renal denervation (RDN) in the treatment of resistant hypertension have been used to estimate the cost-effectiveness of this approach. However, there are no Dutch-specific analyses. This study examined the cost-effectiveness of RDN from the perspective of the healthcare payer in The Netherlands.
  
  
  METHODS
  A previously constructed Markov state-transition model was adapted and updated with costs and utilities relevant to the Dutch setting. The cost-effectiveness of RDN was compared with standard of care (SoC) for patients with resistant hypertension. The efficacy of RDN treatment was modeled as a reduction in the risk of cardiovascular events associated with a lower systolic blood pressure (SBP).
  
  
  RESULTS
  Treatment with RDN compared to SoC gave an incremental quality-adjusted life year (QALY) gain of 0.89 at an additional cost of €1315 over a patient's lifetime, resulting in a base case incremental cost-effectiveness ratio (ICER) of €1474. Deterministic and probabilistic sensitivity analyses (PSA) showed that treatment with RDN therapy was cost-effective at conventional willingness-to-pay thresholds (€10,000-80,000/QALY).
  
  
  CONCLUSIONS
  RDN is a cost-effective intervention for patients with resistant hypertension in The Netherlands.
authors.affiliation: Bresmed Health Solutions , Sheffield , UK.
authors.forename: Thea L
authors.initials: TL
authors.lastname: Henry
authors.forename: Bonnie F E
authors.initials: BF
authors.lastname: De Brouwer
authors.forename: Marjolijn M L
authors.initials: MM
authors.lastname: Van Keep
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Blankestijn
authors.forename: Michiel L
authors.initials: ML
authors.lastname: Bots
authors.forename: Hendrik
authors.initials: H
authors.lastname: Koffijberg
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D003714:Denervation / Q000191:economics* / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000601:surgery*; D007668:Kidney / Q000294:innervation*; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D017059:Models, Econometric; D009426:Netherlands; D019057:Quality-Adjusted Life Years
keywords: Cardiovascular disease; Cost-effectiveness; Prevention; Renal sympathetic denervation; Resistant hypertension