title: Cost estimation of hypertension management based on home blood pressure monitoring alone or combined office and ambulatory blood pressure measurements.
abstract: This study aims at estimating the resources consumed and subsequent costs for hypertension management, using home blood pressure (BP) monitoring (HBPM) alone versus combined clinic measurements and ambulatory blood pressure monitoring (C/ABPM). One hundred sixteen untreated hypertensive subjects were randomized to use HBPM or C/ABPM for antihypertensive treatment initiation and titration. Health resources utilized within 12-months follow-up, their respective costs, and hypertension control were assessed. The total cost of the first year of hypertension management was lower in HBPM than C/ABPM arm (€1336.0 vs. €1473.5 per subject, respectively; P < .001). Laboratory tests' cost was identical in both arms. There was no difference in achieved BP control and drug expenditure (HBPM: €233.1 per subject; C/ABPM: €247.6 per subject; P = not significant), whereas the cost of BP measurements and/or visits was higher in C/ABPM arm (€393.9 vs. €516.9, per patient, respectively P < .001). The cost for subsequent years (>1) was €348.9 and €440.2 per subject, respectively for HBPM and C/ABPM arm and €2731.4 versus €3234.3 per subject, respectively (P < .001) for a 5-year projection. HBPM used alone for the first year of hypertension management presents lower cost than C/ABPM, and the same trend is observed in 5-year projection. The results on the resources consumption can be used to make cost estimates for other health-care systems.
authors.affiliation: Department of Health Economics, National School of Public Health, Athens, Greece.
authors.forename: Nadia
authors.initials: N
authors.lastname: Boubouchairopoulou
authors.affiliation: Hypertension Center, STRIDE Hellas-7, Third University Department of Medicine, Sotiria Hospital, Athens, Greece.
authors.forename: Nikos
authors.initials: N
authors.lastname: Karpettas
authors.affiliation: Department of Health Economics, National School of Public Health, Athens, Greece.
authors.forename: Kostas
authors.initials: K
authors.lastname: Athanasakis
authors.affiliation: Hypertension Center, STRIDE Hellas-7, Third University Department of Medicine, Sotiria Hospital, Athens, Greece.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Kollias
authors.affiliation: Hypertension Unit and Cardiovascular Research Lab, First Department of Internal and Propaedeutic Medicine, Laiko Hospital, Athens, Greece.
authors.forename: Athanase D
authors.initials: AD
authors.lastname: Protogerou
authors.affiliation: Hypertension Center, STRIDE Hellas-7, Third University Department of Medicine, Sotiria Hospital, Athens, Greece.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Achimastos
authors.affiliation: Hypertension Center, STRIDE Hellas-7, Third University Department of Medicine, Sotiria Hospital, Athens, Greece. Electronic address: gstergi@med.uoa.gr.
authors.forename: George S
authors.initials: GS
authors.lastname: Stergiou
mesh_terms: D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use; D018660:Blood Pressure Monitoring, Ambulatory; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics*
chemical_list: D000959:Antihypertensive Agents
keywords: Blood pressure measurement methods; cost effectiveness; economic analysis; hypertension treatment