title: Cost-effectiveness of the introduction of home blood pressure measurement in patients with office hypertension.
abstract: OBJECTIVE
  Cost-effectiveness of hypertension treatment is an important social and medical issue in Western as well as in Eastern countries, including Japan. Home blood pressure (HBP) measurements have a stronger predictive power for cardiovascular events than casual clinic blood pressure (CBP) measurements. Therefore, the introduction of HBP measurement for the diagnosis and treatment of hypertension should lead to a decrease in medical expenditure. This study presents calculations of the cost savings likely to take place when HBP is implemented for newly detected hypertensive subjects in Japan.
  
  
  METHODS
  We estimate the cost savings from the perspective of a Japanese healthcare system. To estimate the costs associated with changing from CBP to HBP measurement as the diagnostic tool, we constructed a simulation model using data from the Ohasama study. These calculations are based on current estimates for cost of treatment, prevalence of white-coat hypertension at baseline, and varying the incidence of new hypertension after the initial screening.
  
  
  RESULTS
  When HBP measurement is not incorporated into the diagnostic process, the medical cost is estimated at US$10.89 million per 1000 subjects per 5 years. When HBP measurement is incorporated, the medical cost is estimated at US$9.33 million per 1000 subjects per 5 years. The reductions in medical costs vary from US$674,000 to US$2.51 million per 1000 subjects per 5 years for treatment of hypertension, when sensitivity analysis is performed.
  
  
  CONCLUSIONS
  The introduction of HBP measurement for the treatment of hypertension is very useful for reducing medical costs.
authors.affiliation: Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan.
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Fukunaga
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.forename: Makoto
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Tamaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kikuya
authors.forename: Taku
authors.initials: T
authors.lastname: Obara
authors.forename: Miwa
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Azusa
authors.initials: A
authors.lastname: Hara
authors.forename: Kei
authors.initials: K
authors.lastname: Asayama
authors.forename: Hirohito
authors.initials: H
authors.lastname: Metoki
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Inoue
authors.forename: Junichiro
authors.initials: J
authors.lastname: Hashimoto
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Totsune
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
mesh_terms: D018660:Blood Pressure Monitoring, Ambulatory / Q000191:economics* / Q000706:statistics & numerical data; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D009313:National Health Programs / Q000191:economics*; D010824:Physicians' Offices; D012680:Sensitivity and Specificity