title: A cost-utility analysis of hypertension treatment in Greece:  assessing the impact of age, sex and smoking status, on outcomes.
abstract: OBJECTIVE
  To assess the cost-utility of hypertension treatment versus a hypothetical 'no-treatment' strategy in Greece.
  
  
  METHODS
  A six-state Markov model simulated the occurrence of major cardiovascular events for hypertensive patients over a 20-year period. Baseline population consisted of a cohort of 1453 patients (46.92% men) that were followed up for a 1-year period, during which health-resource use and clinical characteristics of hypertension were documented. Age, sex and smoking status - specific transition probabilities in the model - were estimated via the HellenicSCORE and Framingham risk equations. The analysis followed a third-party payer perspective.
  
  
  RESULTS
  Incremental cost-effectiveness ratios (ICERs) of treatment versus no treatment were 3539&OV0556;/quality-adjusted life year (QALY), 3986&OV0556;/QALY, 3957&OV0556;/QALY and 5485&OV0556;/QALY gained for men smokers, men nonsmokers, women smokers and women nonsmokers, respectively. ICERs became more favorable with an increase in the years of treatment and advanced age of treatment initiation across all study groups. The probabilistic sensitivity analysis showed that the base-case scenario results were cost-effective for an implicit 30 000&OV0556;/QALY threshold at 97.4, 95.2, 94.8, and 86% of the 10 000 Monte Carlo simulations for men smokers, men nonsmokers, women smokers and women nonsmokers, respectively.
  
  
  CONCLUSIONS
  In the case of hypertension, one of the most prevalent and modifiable diseases/risk factors, that is accompanied by large-scale costs, the above analysis demonstrates that treatment is a highly cost-effective intervention that should be further supported at the patient and the system level.
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, Athens, Greece. kathanasakis@esdy.edu.gr
authors.forename: Kostas
authors.initials: K
authors.lastname: Athanasakis
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Souliotis
authors.forename: Yannis
authors.initials: Y
authors.lastname: Tountas
authors.forename: John
authors.initials: J
authors.lastname: Kyriopoulos
authors.forename: Angelos
authors.initials: A
authors.lastname: Hatzakis
mesh_terms: D000367:Age Factors; D015331:Cohort Studies; D005260:Female; D006115:Greece; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011336:Probability; D012737:Sex Factors; D012907:Smoking