Cost-effectiveness of implementing new guidelines for treatment of hypertension in general practice.
BACKGROUND
Hypertension is a major public health concern and, as the population ages, the size of the problem is likely to increase. However, detection rates and treatment of hypertension have been low. The introduction of new guidelines for the detection and treatment of hypertension have been encouraged but without any consideration to their cost-effectiveness.


OBJECTIVE
To assess the potential cost-effectiveness of implementing new guidelines for the treatment of hypertension in general practice.


METHODS
Model examining the incremental costs and effects of the new guidelines compared with the old.


METHODS
A large general practice in north Yorkshire.


METHODS
Two thousand and twenty-three patients reporting for a new health patient check had the costs and outcomes under the old and new guidelines estimated.


RESULTS
Implementing new guidelines for the detection, management, and treatment of hypertension in a primary care setting is more costly than the implementation of previous guidelines, but more effective in reducing the risk of cardiovascular disease. The incremental cost per cardiovascular disease event avoided is ?30 000, although sensitivity analysis shows that the estimate is subject to considerable uncertainty.


CONCLUSIONS
Compared with previous guidelines, introducing new guidelines for the management and treatment of hypertension in new patients in general practice is likely to be cost-effective. However, the workforce implications for general practitioners (GPs) and practice nurses should be considered.
Richardson
Gerald
G
Centre for Health Economics, University of York, York, UK. gar2@york.ac.uk
Godfrey
Lesley
L
Gravelle
Hugh
H
Watt
Ian
I
D000293:Adolescent; D000328:Adult; D000959:Antihypertensive Agents / Q000191:economics* / Q000627:therapeutic use; D003327:Coronary Disease / Q000191:economics / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D005194:Family Practice / Q000191:economics*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000191:economics*; D008297:Male; D017410:Practice Guidelines as Topic; D012680:Sensitivity and Specificity; D020521:Stroke / Q000191:economics / Q000517:prevention & control
D000959:Antihypertensive Agents