Cost-effectiveness of Antihypertensive Medication: Exploring Race and Sex Differences Using Data From the REasons for Geographic and Racial Differences in Stroke Study.
Antihypertensive medication decreases risk of cardiovascular disease (CVD) events in adults with hypertension. Although black adults have higher prevalence of hypertension and worse CVD outcomes compared with whites, limited attention has been given to the cost-effectiveness of antihypertensive medication for blacks.



To compare the cost-effectiveness of antihypertensive medication treatment versus no-treatment in white and black adults.



We constructed a State Transition Model to assess the costs and quality-adjusted life-years (QALYs) associated with either antihypertensive medication treatment or no-treatment using data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study and published literature. CVD events and health states considered in the model included stroke, coronary heart disease, heart failure, chronic kidney disease, and end-stage renal disease.



White and black adults with hypertension in the United States, 45 years of age and above.



Yearly risk of CVD was determined using REGARDS data and published literature. Antihypertensive medication costs were determined using Medicare claims. Event and health state costs were estimated from published literature. All costs were adjusted to 2012 US dollars. Effectiveness was assessed using QALYs.



Antihypertensive medication treatment was cost-saving and increased QALYs compared with no-treatment for white men ($7387; 1.14 QALYs), white women ($7796; 0.89 QALYs), black men ($8400; 1.66 QALYs), and black women ($10,249; 1.79 QALYs).



Antihypertensive medication treatment is cost-saving and increases QALYs for all groups considered in the model, particularly among black adults.
Departments of *Epidemiology †Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL ‡Department of Health Policy and Management, Indiana University, Indianapolis, IN §Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL.
Gabriel S
GS
Tajeu
Stephen
S
Mennemeyer
Nir
N
Menachemi
Robert
R
Weech-Maldonado
Meredith
M
Kilgore
D001741:Black or African American; D000368:Aged; D000959:Antihypertensive Agents / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D005843:Geography; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D044469:Racial Groups; D012737:Sex Factors; D020521:Stroke / Q000517:prevention & control; D044465:White People
D000959:Antihypertensive Agents