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Cost-effectiveness analysis of intensive blood pressure control in Korea

Ye Seol Lee1,2, Hae-Young Lee3, Tae Hyun Kim4

  • 1Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.

Hypertension Research : Official Journal of the Japanese Society of Hypertension
|December 22, 2021
PubMed

Insights

Intensive blood pressure control is more cost-effective for hypertensive patients over 50, even with higher initial costs. Patient medication adherence significantly impacts cost-effectiveness, highlighting the importance of treatment compliance for preventing cardiovascular disease.

Area of Science:

  • Health Economics
  • Cardiology
  • Public Health

Background:

  • Hypertension management is crucial for preventing cardiovascular disease (CVD).
  • Cost-effectiveness analysis (CEA) informs optimal treatment strategies for chronic conditions like hypertension.
  • Understanding the economic impact of intensive versus standard blood pressure (BP) control is vital for healthcare policy.

Purpose of the Study:

  • To conduct a cost-effectiveness analysis of intensive versus standard BP control in Korean hypertensive patients.
  • To evaluate the impact of varying medication adherence levels on the cost-effectiveness of intensive BP control.
  • To determine if intensive BP control is a cost-effective strategy within Korea's willingness-to-pay threshold.

Main Methods:

  • A Markov model was constructed to compare intensive (SBP < 120 mmHg) and standard (SBP < 140 mmHg) BP control.
  • Quality-adjusted life years (QALYs) were used as the effectiveness measure, incorporating medical and nonmedical costs.
  • Five scenarios with different medication adherence rates were analyzed, alongside sensitivity and tornado analyses.

Main Results:

  • Intensive BP control demonstrated lower incremental cost-effectiveness ratios (ICERs) across all adherence scenarios compared to standard care.
  • The lowest ICER of $1,373 USD was observed with 100% medication adherence.
  • All calculated ICERs fell below Korea's willingness-to-pay (WTP) threshold, indicating cost-effectiveness.

Conclusions:

  • Intensive blood pressure control is a more cost-effective strategy for managing hypertension and preventing cardiovascular disease in high-risk patients.
  • Optimizing patient medication adherence is critical for maximizing the cost-effectiveness of intensive hypertension treatment.
  • The findings support the adoption of intensive BP control strategies within healthcare systems, contingent on adherence support.

Keywords:
Cardiovascular diseaseCost-effectiveness analysisHypertensionIntensive blood pressure control

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