[Cost effectiveness of hypertension treatment based on the measurement of ambulatory blood pressure].
In recent years soaring medical costs have become a major social problem in developed countries. Ambulatory blood pressure (ABP) measurements have a stronger predictive power for cardiovascular events than clinic blood pressure (CBP) measurements. Therefore the introduction of ABP measurement for the diagnosis and treatment of hypertension should lead to a decrease in medical expenditure. This study presents calculations of the cost saving and life years associated with changing from CBP to ABP measurement as diagnostic tool. We constructed a Markov model using data from the Ohasama study and a Japanese national database. Study population was 7.042 million individuals aged 40 years and above living in Japan. The introduction of ABP for hypertension would result in a reduction of about 9.48 trillion yen per 10 years. We conducted a sensitivity analysis and found that the introduction of ABP was associated with at least a cost reduction of 47500 billion yen. But it did not provide significant extension of average life years. However the introduction of ABP for hypertension treatment would be a very effective method in perspective of public health because it reduced about 59600 individuals of stroke and about 18900 individuals of death. Given its cost-effectiveness, extensive application of ABP measurement in clinical practice is expected.
Tamaki
Yuichiro
Y
Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences.
Ohkubo
Takayoshi
T
Kobayashi
Makoto
M
Sato
Keiko
K
Kikuya
Masahiro
M
Obara
Taku
T
Metoki
Hirohito
H
Asayama
Kei
K
Hirose
Takuo
T
Totsune
Kazuhito
K
Suzuki
Kazuo
K
Imai
Yutaka
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018660:Blood Pressure Monitoring, Ambulatory / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D020521:Stroke / Q000191:economics / Q000209:etiology / Q000517:prevention & control