OBJECTIVES: Cardiovascular diseases result in an enormous burden to society. Therefore, early identification of and pharmacotherapeutic intervention in subjects at risk for cardiovascular morbidity and mortality is highly desirable. Elevated albuminuria levels have proven to predict worse cardiovascular outcomes. The aim of our study was to estimate the cost-effectiveness and of a population-based ‘screen-and-treat’ procedures directed at albuminuria. METHODS: A formal cost-effectiveness analysis was conducted using a Markov-model for disease progression. The model consist of 8 health states defined by urinary albumine excretion (UAE) classification (UAE<15 mg/day (low-normo), UAE 15-30 mg/day (high-normo), UAE 30-300 mg/day (micro), ≥300 mg/day (macro)), cardiovascular morbidity, cardiovascular mortality, non-cardiovascular mortality and renal disease (e.g. dialysis). Input-variables for transitions between albuminuria-based Markov stages and effects of blood pressure lowering agents were derived from the observational PREVEND cohort study and PREVEND-IT clinical trial. All costs were presented in 2008 values and the cost-effectiveness analysis was performed following the Dutch guidelines for conducting pharmacoeconomic research. RESULTS: Early results for screening the Dutch population on albuminuria (≥15 mg/day) and subsequent ACE-inhibitor treatment in those found positive, suggests a crude cost-effectiveness of €29,300 per life year gained (LYG). Treating only those subjects with microalbuminuria (≥30 mg/day) resulted to be more favorable with a cost-effectiveness of  €9700 per LYG. Furthermore, restricting screening to only those subjects aged >50 or >60 years resulted in a cost-effectiveness of respectively €15,000 and €10,200 per LYG. These age-dependent figures were even more favorable in those subjects with microalbuminuria. Our preliminary results suggest a favorable cost-effectiveness outcome below the (informal) Dutch pharmacoeconomic threshold of €20,000 per LYG. CONCLUSIONS: Next to the cost-effectiveness outcomes from the PREVEND-IT economic evaluation, our results on observational data suggest favorable cost-effectiveness outcomes for a population-based ‘screen-and-treat’ procedure on albuminuria. Definite results including probabilistic sensitivity analyses will be presented during the conference.