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Cost effectiveness of an adherence-improving programme in hypertensive patients
Danielle E M Brunenberg1, Gwenn E C Wetzels, Patricia J Nelemans
1Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, Maastricht, The Netherlands.
Pharmacoeconomics
|March 6, 2007
Summary
The Medication Events Monitoring System (MEMS) showed moderate cost-effectiveness for improving adherence in hypertensive patients. Further research is needed due to uncertainty, but MEMS may help when BP targets aren't met.
Area of Science:
- Pharmacoeconomics
- Health Services Research
- Cardiology
Background:
- High non-adherence to antihypertensive drugs poses significant economic challenges.
- The Medication Events Monitoring System (MEMS) is a proven tool for managing adherence issues.
Purpose of the Study:
- To evaluate the cost-effectiveness of MEMS compared to usual care for hypertensive patients with poor adherence.
- The MEMS program included electronic monitoring and adherence training.
Main Methods:
- A randomized controlled trial followed 164 patients with MEMS and 89 with usual care for 5 months.
- Eligible patients had uncontrolled blood pressure despite antihypertensive medication.
- Outcomes included normalized blood pressure (NBP) and quality-adjusted life years (QALYs), with cost analysis from healthcare and societal perspectives.
Main Results:
- No significant difference in NBP or QALYs was detected between groups at 5 months.
- The MEMS group had a statistically significant lower rate of medication dose escalation.
- Cost-effectiveness probability ranged from 75-80% (healthcare perspective, NBP) and 45-51% (societal perspective, QALYs).
Conclusions:
- A 5-month adherence-improving program using MEMS showed no clear cost or effect advantage over usual care.
- The cost-effectiveness of MEMS is moderately probable but uncertain, warranting further research.
- MEMS may benefit patients with uncontrolled BP due to suspected non-adherence when dose escalation is undesirable.
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