Cost-effectiveness of impedance cardiography testing in uncontrolled hypertension.
To evaluate the short- and long-term cost-effectiveness of impedance cardiography (ICG) testing in uncontrolled hypertensives, we analyzed the Consideration of Noninvasive Hemodynamic Monitoring to Target Reduction of Blood Pressure Levels (CONTROL) trial results that compared the blood pressure-lowering effects of standard vs ICG care. Short-term cost-effectiveness was evaluated as the incremental cost per incremental mm Hg reduced during the trial. Long-term cost-effectiveness was evaluated as incremental cost per quality-adjusted life-year gained over 10 years. ICG care short-term cost-effectiveness was 20 US dollar per incremental mm Hg reduced for systolic blood pressure (vs standard care, 36 US dollar per mm Hg reduced) and 23 US dollar per incremental mm Hg reduced for diastolic blood pressure (vs standard care, 79 US dollar per mm Hg reduced). In the long term, ICG resulted in a 476 US dollar cost savings and 0.109 quality-adjusted life-years gained per patient (-4,371 US dollar per quality-adjusted life-year gained, sensitivity analysis -8,764 to 13,163 US dollar). The use of ICG testing to reduce blood pressure in uncontrolled hypertensive patients is cost-effective from both a short- and long-term perspective.
Ferrario
Carlos M
CM
Hypertension and Vascular Disease Center, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. cferrari@wfubmc.edu
Smith
Ronald D
RD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002307:Cardiography, Impedance / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D000959:Antihypertensive Agents