Long Term Cost-Effectiveness of a Systolic Blood Pressure Goal of <120 mmHg in Hypertensive Patients Without Diabetes Mellitus

Abstract

Objectives

To determine the cost-effectiveness of intensive blood pressure (BP) treatment in patients at high risk for cardiovascular disease (CVD) over their lifetime in Saudi Arabia.

Methods

A Markov model was developed for the BP strategies to estimate the added lifetime costs and quality-adjusted life-years (QALYs) gained. These 2 items were then used to develop an incremental cost-effectiveness ratio (ICER). Event rates were estimated from the Systolic Blood Pressure Intervention Trial, and the other model inputs were retrieved from previous studies. Estimated costs were collected from 5 private hospitals in Riyadh, Saudi Arabia. The model used a lifetime framework adopting healthcare payer in Saudi Arabia. Sensitivity analysis was conducted using 1-way and probabilistic sensitivity analysis to evaluate the robustness and uncertainty of the estimates.

Results

Over a 30-year period, intensive BP therapy would be cost-effective compared with the standard treatment with incremental costs per QALY, in US dollars, of $24 056. Probabilistic sensitivity analysis suggested intensive BP treatment would be cost-effective compared with standard treatment 86.7% of the time at a willingness-to-pay threshold of $$60 000 per QALY.

Conclusion

The result of this study showed that intensive BP treatment appears to be a cost-effective choice for patients with a high risk of CVD in Saudi Arabia when compared with standard treatment.

Authors

Ziyad S. Almalki Mohammed Shahid Iqbal Faisal M. Alablan Raed K. Alenazi Abdullah R. Tasha Mohammed F. Daghar Naif M. Aldossary

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