Comparative Cost-Effectiveness of Hypertension Treatment in Non-Hispanic Blacks and Whites According to 2014 Guidelines: A Modeling Study
| Autor: | Eshan Vasudeva, Lee Goldman, Andrew E. Moran, Antoinette Mason, Chen Huang, Kirsten Bibbins-Domingo, Pamela G. Coxson, Nathalie Moise, Joanne Penko |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Gerontology Comparative Effectiveness Research Cardiovascular system--Diseases Cost effectiveness Cost-Benefit Analysis 030204 cardiovascular system & hematology Cardiovascular 0302 clinical medicine Models Medicine African Americans--Medical care 030212 general & internal medicine race health care economics and organizations Cost–benefit analysis Hypertension treatment blood pressure Health Services Middle Aged Cost savings Medical care--Cost effectiveness Models Economic Hypertension Practice Guidelines as Topic Blood pressure Female Adult hypertension Clinical Sciences Economic 03 medical and health sciences Clinical Research Diabetes mellitus Internal Medicine Humans cost-effectiveness Antihypertensive Agents Aged business.industry Prevention medicine.disease Quality-adjusted life year Good Health and Well Being Cost Effectiveness Research Cardiovascular System & Hematology Commentary Hypertension--Treatment business |
| Zdroj: | American journal of hypertension, vol 29, iss 10 |
| ISSN: | 1941-7225 0895-7061 |
| DOI: | 10.1093/ajh/hpw047 |
| Popis: | BACKGROUND: We compared the cost-effectiveness of hypertension treatment in non-Hispanic blacks and non-Hispanic whites according to 2014 US hypertension treatment guidelines. METHODS: The cardiovascular disease (CVD) policy model simulated CVD events, quality-adjusted life years (QALYs), and treatment costs in 35- to 74-year-old adults with untreated hypertension. CVD incidence, mortality, and risk factor levels were obtained from cohort studies, hospital registries, vital statistics, and national surveys. Stage 1 hypertension was defined as blood pressure 140-149/90-99mm Hg; stage 2 hypertension as ≥150/100mm Hg. Probabilistic input distribution sampling informed 95% uncertainty intervals (UIs). Incremental cost-effectiveness ratios (ICERs) < $50,000/QALY gained were considered cost-effective. RESULTS: Treating 0.7 million hypertensive non-Hispanic black adults would prevent about 8,000 CVD events annually; treating 3.4 million non-Hispanic whites would prevent about 35,000 events. Overall 2014 guideline implementation would be cost saving in both groups compared with no treatment. For stage 1 hypertension but without diabetes or chronic kidney disease, cost savings extended to non-Hispanic black males ages 35-44 but not same-aged non-Hispanic white males (ICER $57,000/QALY; 95% UI $15,000-$100,000) and cost-effectiveness extended to non-Hispanic black females ages 35-44 (ICER $46,000/QALY; $17,000-$76,000) but not same-aged non-Hispanic white females (ICER $181,000/QALY; $111,000-$235,000). CONCLUSIONS: Compared with non-Hispanic whites, cost-effectiveness of implementing hypertension guidelines would extend to a larger proportion of non-Hispanic black hypertensive patients. |
| Databáze: | OpenAIRE |
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