A review of cost-effectiveness analyses of hypertension treatment

In this paper cost-effectiveness analyses of hypertension treatment are reviewed. Nine studies using life-years gained or quality-adjusted life-years gained as outcome measure are identified, summarised, and their results analysed. It is noted that there is a lack of methodological conformity between the studies, which makes comparisons difficult. The only consistent finding among the studies is that the cost-effectiveness increased with higher pretreatment blood pressure. The studies also indicated that treatment of hypertension is more cost-effective in younger men than in younger women, and that cost-effectiveness increases with age for both men and women. It is impossible at present to draw any policy conclusions from the cost-effectiveness analyses comparing different drugs, owing to poor methodology and insufficient data. For the future it is important to upgrade the quality of the cost-effectiveness analyses in this area by improving both the data and the methodology used. There is also a need to complement cost-effectiveness analysis with other approaches, for example willingness to pay.