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Cost implications of improving blood pressure management among U.S. adults

Teryl K Nuckols1, Julia E Aledort, John Adams

  • 1RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, USA. teryl@rand.org

Health Services Research
|February 11, 2011
PubMed

Insights

Improving blood pressure management costs payers more but is cost-effective for moderate hypertension. A relaxed goal significantly increases payer incentives for severe hypertension care.

Area of Science:

  • Health Economics
  • Cardiovascular Disease Management
  • Public Health Policy

Background:

  • Effective blood pressure management is crucial for preventing cardiovascular events.
  • Current care processes and goal attainment rates vary, impacting patient outcomes and healthcare costs.
  • Payer perspectives are essential for understanding the financial implications of improving hypertension treatment.

Purpose of the Study:

  • To evaluate the cost-effectiveness of enhanced blood pressure management strategies from a payer's viewpoint.
  • To determine the financial impact of achieving recommended blood pressure treatment goals.
  • To compare the cost-effectiveness of improving care for moderate versus severe hypertension.

Main Methods:

  • Utilized medical records from 4,500 U.S. adults with hypertension (Community Quality Index study).
  • Analyzed pharmaceutical claims and Medicare fee schedules to estimate costs.
  • Modeled blood pressure management over 2 years using a probability tree to assess care processes, goal attainment, and associated costs.

Main Results:

  • Improved blood pressure care incurs an additional cost of $170 per hypertensive person annually for payers.
  • The incremental cost to achieve treatment goals over 2 years is $1,696 overall, $801 for moderate, and $850 for severe hypertension.
  • A relaxed goal (≤ stage 1) for severe hypertension costs $185 per person, substantially increasing goal attainment.

Conclusions:

  • Improving care for moderate hypertension is more cost-effective for payers than for severe hypertension under current monitoring programs.
  • Implementing a secondary, relaxed blood pressure goal significantly enhances payer incentives for managing severe hypertension.
  • These findings can inform policy decisions regarding hypertension treatment targets and reimbursement strategies.
Abstract

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