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J Hypertens. 2008 Apr;26(4):685-90. doi: 10.1097/HJH.0b013e3282f42285.

Cost-effectiveness of the introduction of home blood pressure measurement in patients with office hypertension.

Author information

1
Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan.

Abstract

OBJECTIVE:

Cost-effectiveness of hypertension treatment is an important social and medical issue in Western as well as in Eastern countries, including Japan. Home blood pressure (HBP) measurements have a stronger predictive power for cardiovascular events than casual clinic blood pressure (CBP) measurements. Therefore, the introduction of HBP measurement for the diagnosis and treatment of hypertension should lead to a decrease in medical expenditure. This study presents calculations of the cost savings likely to take place when HBP is implemented for newly detected hypertensive subjects in Japan.

DESIGN AND METHODS:

We estimate the cost savings from the perspective of a Japanese healthcare system. To estimate the costs associated with changing from CBP to HBP measurement as the diagnostic tool, we constructed a simulation model using data from the Ohasama study. These calculations are based on current estimates for cost of treatment, prevalence of white-coat hypertension at baseline, and varying the incidence of new hypertension after the initial screening.

RESULTS:

When HBP measurement is not incorporated into the diagnostic process, the medical cost is estimated at US$10.89 million per 1000 subjects per 5 years. When HBP measurement is incorporated, the medical cost is estimated at US$9.33 million per 1000 subjects per 5 years. The reductions in medical costs vary from US$674,000 to US$2.51 million per 1000 subjects per 5 years for treatment of hypertension, when sensitivity analysis is performed.

CONCLUSIONS:

The introduction of HBP measurement for the treatment of hypertension is very useful for reducing medical costs.

PMID:
18327077
DOI:
10.1097/HJH.0b013e3282f42285
[Indexed for MEDLINE]

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