title: Health care cost of analgesic use in hypertensive patients.
abstract: BACKGROUND
  Hypertension is one of the most frequently diagnosed chronic medical conditions in the United States and imposes a substantial financial and social burden on Americans.
  
  
  OBJECTIVE
  The aim of this study was to compare the cost of health care resources for hypertensive patients taking analgesics stratified by having controlled versus uncontrolled hypertension.
  
  
  METHODS
  This was a retrospective, database analysis of data for managed-care patients in Maryland and Washington, DC, recorded from February 1, 1999, to July 31, 2001. Hypertensive patients who were taking analgesics were stratified by their hypertension control status using a claims-based algorithm. Annualized costs and differences in annualized costs calculated for the periods before and after the initiation of analgesics were compared by patient hypertension control status.
  
  
  RESULTS
  Of the 9805 patients in the study (mean [SD] age, 49.8 [12.04] years), 2523 (25.73%) were categorized as having uncontrolled hypertension. The mean total annualized costs differed significantly between the controlled and uncontrolled hypertension groups by 2568 dollars (P < 0.001). The annualized costs for emergency-department visits and hospitalizations for uncontrolled hypertensive patients exceeded those for controlled hypertensive patients by 9.3% and 28.0%, respectively. The differences between the postindex- and preindex-period costs for health care resources were 1972 dollars with controlled hypertension and 2961 dollars with uncontrolled hypertension (P < 0.001). The results of linear regression, after adjustments were made for preindex costs and other covariates, indicated that patients with uncontrolled hypertension had significantly increased billed annualized costs (P < 0.001).
  
  
  CONCLUSIONS
  These data suggest that the costs of health care resources were significantly higher for analgesic users with uncontrolled hypertension than for analgesic users with controlled hypertension. A considerable proportion of the cost differential was directly attributable to hypertension-related treatment care.
authors.affiliation: Center on Drugs and Public Policy, University of Maryland School of Pharmacy, Baltimore, Maryland, USA. dmullins@rx.maryland.edu
authors.forename: C Daniel
authors.initials: CD
authors.lastname: Mullins
authors.forename: Fadia T
authors.initials: FT
authors.lastname: Shaya
authors.forename: Louis R
authors.initials: LR
authors.lastname: Flowers
authors.forename: Elijah
authors.initials: E
authors.lastname: Saunders
authors.forename: Wallace
authors.initials: W
authors.lastname: Johnson
authors.forename: Winston
authors.initials: W
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage / Q000191:economics*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000191:economics*; D016208:Databases, Factual; D004219:District of Columbia; D017850:Economics, Pharmaceutical; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000191:economics*; D008297:Male; D008329:Managed Care Programs / Q000191:economics; D008396:Maryland; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal