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Volume 26, Number 2—February 2020
Research

Cost-effectiveness of Screening Program for Chronic Q Fever, the Netherlands

Pieter T. de BoerComments to Author , Marit M.A. de Lange, Cornelia C.H. Wielders, Frederika Dijkstra, Sonja E. van Roeden, Chantal P. Bleeker-Rovers, Jan Jelrik Oosterheert, Peter M. Schneeberger, and Wim van der Hoek
Author affiliations: National Institute for Public Health and the Environment, Bilthoven, the Netherlands (P.T. de Boer, M.M.A. de Lange, C.C.H. Wielders, F. Dijkstra, W. van der Hoek); University Medical Centre Utrecht, Utrecht, the Netherlands (S.E. van Roeden, J.J. Oosterheert); Radboud university medical center, Nijmegen, the Netherlands (C.P. Bleeker-Rovers); Jeroen Bosch Hospital, ’s-Hertogenbosch, the Netherlands (P.M. Schneeberger)

Main Article

Table 3

Outcomes of screening for chronic Q fever when a participation rate of 50% was assumed, the Netherlands, 2017*

Target population
 CQF prevalence scenario
 CQF prevalence
 Persons screened
 CQF patients detected
 Proven CQF patients detected
 Complications prevented
 Surgeries prevented
 Deaths prevented
 QALYs gained
 Total cost difference, 
€, millions
 ICER, €/QALY gained
High incidence area
CVRF patients Low 644 27,911 18.0 12.4 8.4 4.3 2.1 17.1 0.54 31,737
High 6,245 36,098 225.4 155.4 104.7 53.9 25.8 214.9 −0.07 Cost-saving
Immunocompromised patients Low 364 26,898 9.8 6.7 4.5 2.3 1.1 9.3 0.62 66,145
High 3,525 34,789 122.6 84.5 56.9 29.3 14.0 116.9 0.27 2,312
Age >60 y, unknown risk factor Low 41.6 219,247 9.1 4.8 3.2 1.6 0.8 6.6 4.46 679,136
High 305 283,564 86.4 59.6 40.1 20.7 9.9 82.4 5.70 69,208
Age 18–59 y, unknown risk factor Low 11.0 551,381 6.1 0.2 0.1 0.1 0 0.2 16.23 76,308,665
High 3.9 713,133 2.8 1.9 1.3 0.7 0.3 2.7 21.41 8,029,064
Middle incidence area
CVRF patients Low 45.5 44,586 2.0 1.4 0.9 0.5 0.2 1.9 0.96 495,918
High 1,342 61,503 82.6 56.9 38.3 19.7 9.4 78.7 1.02 12,929
Immunocompromised patients Low 25.7 42,969 1.1 0.8 0.5 0.3 0.1 1.1 1.04 990,755
High 758 59,273 44.9 30.9 20.9 10.7 5.1 42.8 1.23 28,755
Age >60 y, unknown risk factor Low 2.9 350,237 1.0 0.5 0.4 0.2 0.1 0.7 7.12 9,610,222
High 65.5 483,129 31.7 21.8 14.7 7.6 3.6 30.2 9.80 324,632
Age 18–59 y, unknown risk factor Low 0.78 880,807 0.7 0 0 0 0 0 25.83 1,077,459,984
High
 0.84
 1,215,017
 1.0
 0.7
 0.5
 0.2
 0.1
 1.0
 35.80
 36,661,479
Low incidence area
CVRF patients Low 8.2 158,759 1.3 0.9 0.6 0.3 0.1 1.2 3.43 2,757,608
High 584 133,654 78.0 53.8 36.2 18.7 8.9 74.4 2.60 34,912
Immunocompromised patients Low 4.64 153,001 0.7 0.5 0.3 0.2 0.1 0.7 3.72 5,495,846
High 329 128,807 42.4 29.2 19.7 10.1 4.9 40.5 2.93 72,544
Age >60 y, unknown risk factor Low 0.53 1,247,109 0.7 0.3 0.2 0.1 0.1 0.5 25.35 53,126,291
High 28.5 1,049,899 29.9 20.6 13.9 7.2 3.4 28.5 21.32 747,603
Age 18–59 y, unknown risk factor Low 0.14 3,136,344 0.4 0 0 0 0 0 91.94 5,955,497,518
High 0.37 2,640,382 1.0 0.7 0.4 0.2 0.1 0.9 77.57 84,075,394

*Results are stratified by target population and prevalence. CVRF, cardiovascular risk factor; QALY, quality-adjusted life year.
†Per million population.

Main Article

Page created: January 17, 2020
Page updated: January 17, 2020
Page reviewed: January 17, 2020
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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