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Cost-Effectiveness of a Workplace-Based Hypertension Management Program in Real-World Practice in the Kailuan Study
Yan-Feng Zhou1, Shuohua Chen2, Jun-Xiang Chen3
1Department of Social Medicine, School of Public Health Guangxi Medical University Nanning China.
Insights
Workplace hypertension management for men with high blood pressure is cost-effective. This program improves quality-adjusted life years (QALYs) and life-years, offering a valuable healthcare intervention.
Area of Science:
- Public Health
- Health Economics
- Cardiovascular Disease Management
Background:
- A workplace-based hypertension management program was established in 2009 for men in the Kailuan study.
- The program included semimonthly blood pressure monitoring, free medications, and personalized health consultations.
- The cost-effectiveness of this intervention was previously undetermined.
Purpose of the Study:
- To evaluate the cost-effectiveness of a workplace-based hypertension management program compared to routine care.
- To analyze costs, quality-adjusted life years (QALYs), and life-years from both a 10-year follow-up and a lifetime perspective.
- To assess the economic value of workplace interventions for hypertension in a Chinese male population.
Main Methods:
- A microsimulation model was developed using 10-year follow-up data from the Kailuan study.
- The analysis included 12,240 participants, divided equally into management and control groups.
- Cost-effectiveness was determined using incremental cost-effectiveness ratios (ICERs) and probabilistic sensitivity analyses.
Main Results:
- Over 10 years, the management group gained 0.06 QALYs at an incremental cost of $633.17.
- Lifetime projections indicated an increase of 0.88 QALYs or 0.92 life-years with an incremental cost of $1638.64.
- The ICER was $1855.47 per QALY gained and $1780.27 per life-year gained.
- Probabilistic sensitivity analysis showed a 100% likelihood of cost-effectiveness at a willingness-to-pay threshold of $30,765 per QALY.
Conclusions:
- Workplace-based hypertension management is a cost-effective strategy compared to routine care for Chinese men.
- The intervention demonstrates value both during the study period and over a lifetime.
- This model may be beneficial for working populations with hypertension in China and globally.
Background:
In 2009, a workplace-based hypertension management program was launched among men with hypertension in the Kailuan study. This program involved monitoring blood pressure semimonthly, providing free antihypertensive medications, and offering personalized health consultations. However, the cost-effectiveness of this program remains unclear.
Methods And Results:
This analysis included 12 240 participants, with 6120 in each of the management and control groups. Using a microsimulation model derived from 10-year follow-up data, we estimated costs, quality-adjusted life years (QALYs), life-years, and incremental cost-effectiveness ratios (ICERs) for workplace-based management compared with routine care in both the study period and over a lifetime. Analyses are conducted from the societal perspective. Over the 10-year follow-up, patients in the management group experienced an average gain of 0.06 QALYs with associated incremental costs of $633.17 (4366.85 RMB). Projecting over a lifetime, the management group was estimated to increase by 0.88 QALYs or 0.92 life-years compared with the control group, with an incremental cost of $1638.64 (11 301.37 RMB). This results in an incremental cost-effectiveness ratio of $1855.47 per QALY gained and $1780.27 per life-year gained, respectively, when comparing workplace-based management with routine care. In probabilistic sensitivity analyses, with a threshold willingness-to-pay of $30 765 per QALY (3 times 2019 gross domestic product per capita), the management group showed a 100% likelihood of being cost-effective in 10 000 samples.
Conclusions:
Workplace-based management, compared with routine care for Chinese men with hypertension, could be cost-effective both during the study period and over a lifetime, and might be considered in working populations in China and elsewhere.
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