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.