Cost-Effectiveness of Masked Hypertension Screening and Treatment
2022
The study assessed the health and economic outcomes of screening and treating masked hypertension in U.S. adults using the Cardiovascular Disease (CVD) Policy Model, a microsimulation model. The model simulated 100,000 adults suspected of having masked hypertension (office blood pressure [BP] of 120–129/<80 mm Hg, not on antihypertensive medications, and without a history of CVD).
Interventions included: usual care alone, usual care with ambulatory BP monitoring (ABPM), and usual care with home BP monitoring (HBPM). Outcomes included total direct healthcare costs (in 2021 USD), quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios, with future costs and QALYs discounted at 3% annually. Secondary outcomes included the number of CVD events and serious adverse events related to treatment.
The results indicated that adding ABPM or HBPM to usual care could prevent 14.3 and 20.5 CVD events per 100,000 person-years, respectively, although was associated with an increase in treatment-related serious adverse events and an increase in mean total costs. Compared with usual care, adding ABPM was estimated to cost $85,200 per QALY gained, but adding HBPM resulted in lower QALYs than usual care due to increased treatment-related adverse events and pill-taking disutility.
Cost-Effectiveness of Masked Hypertension Screening and Treatment
Source:
Green MB, Shimbo D, Schwartz JE et al. Cost-Effectiveness of Masked Hypertension Screening and Treatment in US Adults with Suspected Masked Hypertension: A Simulation Study. American Journal of Hypertension 2022; 35 (8): 752-762. https://doi.org/10.1093/ajh/hpac071