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Cost analysis of ambulatory blood pressure monitoring in initiating antihypertensive drug treatment in Australian general practice
Author(s) -
Ewald Ben,
Pekarsky Brita
Publication year - 2002
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2002.tb04588.x
Subject(s) - medicine , white coat hypertension , ambulatory blood pressure , ambulatory , blood pressure , pharmacotherapy , antihypertensive drug , cost effectiveness analysis , intensive care medicine , emergency medicine , pharmacoeconomics , cost effectiveness , risk analysis (engineering)
Objective: To compare the cost of ambulatory blood pressure monitoring (ABPM) with the putative savings made through treatment avoided by identification and non‐treatment of those with “white coat” hypertension. Design: A cost analysis based on a model of four alternative strategies (no ABPM, yearly, two‐yearly, or three‐yearly monitoring) over a seven‐year period applied to a case series from Australian general practice. Participants: 62 patients newly diagnosed by their GPs as having hypertension and requiring drug treatment. Main outcome measures: The proportion of patients shown to not need treatment. The discounted costs to the Pharmaceutical Benefits Scheme, Medical Benefits Scheme and patients. Results: 16 of 62 patients (26%; 95% CI, 15%–37%) were normotensive on ABPM and did not require treatment. All monitoring strategies are more expensive in the first year, but the initial costs are offset by year 3 and the monitoring strategies are cost saving thereafter. Sensitivity analysis shows that this result holds across a range of costs of pharmacotherapy and proportion of patients with white coat hypertension. Conclusion: The additional costs of 24‐hour ABPM in the first year are offset by savings associated with patients with white coat hypertension who would otherwise have been treated.