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The costs of treating hypertension--an analysis of different cut-off points
M Johannesson1, L Borgquist, B Jönsson
1Department of Health and Society, Linköping University, Sweden.
Insights
Lowering hypertension treatment thresholds significantly increases drug costs. A 5 mm Hg decrease in the diastolic blood pressure cut-off point could raise annual spending by millions, impacting healthcare budgets.
Area of Science:
- Health Economics
- Cardiology
- Public Health Policy
Background:
- Hypertension treatment guidelines vary globally.
- Establishing optimal diastolic blood pressure (DBP) cut-off points for drug initiation is crucial for cost-effectiveness.
- Current Swedish DBP treatment thresholds are compared against international standards.
Purpose of the Study:
- To analyze the economic impact of different diastolic blood pressure cut-off points for hypertension drug treatment.
- To estimate the potential annual costs associated with lowering DBP treatment thresholds in Sweden.
Main Methods:
- Utilized a theoretical blood pressure distribution model for Sweden.
- Calculated potential annual treatment costs for various DBP cut-off points (105, 100, and 95 mm Hg).
- Compared estimated costs with the British treatment threshold (100 mm Hg).
Main Results:
- Lowering the DBP cut-off from 105 to 100 mm Hg could increase annual costs by ~£80 million.
- A further reduction from 100 to 95 mm Hg might raise costs by ~£110 million.
- Treating all individuals with DBP ≥ 95 mm Hg (approx. 1.6 million) could cost ~£40 per capita annually, 50% more than the UK's 100 mm Hg threshold.
Conclusions:
- The chosen DBP cut-off point for hypertension treatment significantly influences national healthcare expenditure.
- The Swedish DBP treatment threshold of 95 mm Hg is projected to incur substantially higher costs compared to the UK's 100 mm Hg threshold.
- Economic evaluations are essential for optimizing hypertension management strategies and resource allocation.
Abstract:
In this article the effects of different cut-off points for hypertension treatment are analysed, with respect to treatment costs. A theoretical blood pressure distribution is used to calculate the potential annual cost of treating all persons in Sweden above certain cut-off points for drug treatment. A lowering of the cut-off point from 105 mm Hg to 100 mm Hg diastolic blood pressure could potentially lead to an increase in annual costs of approximately 80m pounds. Further lowering from 100 to 95 mm Hg in turn could increase annual costs by about 110m pounds. The potential annual cost of treating all persons (roughly 1.6 million) with a diastolic blood pressure of greater than or equal to 95 mm Hg with drugs is calculated as being roughly 40 pounds per inhabitant in Sweden. The Swedish cut-off point for treatment (95 mm Hg) can be expected to lead to roughly 50 per cent higher treatment costs than the British cut-off point (100 mm Hg).