title: Cost-effectiveness evaluation of a home blood pressure monitoring program.
abstract: OBJECTIVE
  To evaluate the health system cost of a home blood pressure monitoring (HBPM) program versus usual care in an integrated healthcare system.
  
  
  METHODS
  This cost-effectiveness analysis was based upon a previously completed randomized controlled trial of 348 hypertensive patients, in which mean systolic blood pressure (BP) was lowered 21 versus 8 mm Hg in the HBPM and usual care groups, respectively, and BP control was achieved in 54% versus 35% of patients (P < .001).
  
  
  METHODS
  This analysis compared direct costs from the health plan perspective, including clinic visits, e-mail and telephone encounters, laboratory tests, medications, hospitalizations, and emergency department visits between the 2 groups. Primary outcomes were the incremental hypertension care-related cost of HBPM per mm Hg lowering of systolic BP per patient, per additional BP controlled, and per life-year gained.
  
  
  RESULTS
  Median hypertension-related cost per patient over 6 months was $455 in the HBPM group and $179 for usual care (P < .001). This increase was attributable to additional e-mail and telephone encounters, greater antihypertensive medication use, additional laboratory monitoring, and the BP monitor. Median total cost per patient was $1530 and $1283 for the HBPM and usual care groups, respectively (P = .034). The HBPM program increased hypertension-related expenditures by $20.50 per mm Hg lowering of systolic BP, $1331 per additional patient achieving BP control at 6 months, and $3330 per life-year gained.
  
  
  CONCLUSIONS
  The HBPM program requires investment in outpatient encounters, medications, and laboratory monitoring, but produces significantly improved BP control.
authors.affiliation: 16601 Centretech Pkwy, Aurora, CO 80011. E-mail: sarah.j.billups@kp.org.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Billups
authors.forename: Lindsy R
authors.initials: LR
authors.lastname: Moore
authors.forename: Kari L
authors.initials: KL
authors.lastname: Olson
authors.forename: David J
authors.initials: DJ
authors.lastname: Magid
mesh_terms: D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use; D018660:Blood Pressure Monitoring, Ambulatory / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000191:economics; D008297:Male; D008875:Middle Aged
chemical_list: D000959:Antihypertensive Agents