2.7 A HEALTH ECONOMIC EVALUATION ON THE COST EFFECTIVENESS OF HYPERTENSION MANAGEMENT GUIDED BY CENTRAL BLOOD PRESSURE MEASUREMENT: ANALYSIS OF THE BPGUIDE STUDY

Abstract

Objectives. The BPGUIDE study was a prospective, blinded-endpoint study in 286 hypertensive patients randomised to treatment decisions guided by best-practice usual care (n = 142) or in addition by central BP measurement (n = 144; using SphygmoCor) over twelve months. This study aimed to undertake a health economic assessment to determine cost-effectiveness of hypertension management guided by central BP. Methods. The primary finding of BPGUIDE was that significantly (p < 0.001) less antihypertensive medication was used to achieve BP control in patients randomised to central BP guided care.The savings from these reductions in medications were used to determine the cost-effective fee for service and this amount was then compared to the actual financial cost of central BP measurement in order to gauge financial viability. Results. Decreases in 5 antihypertensive medication classes over time were used to calculate financial savings using the Australian Government’s Pharmaceutical Benefits Scheme dollar costs. Savings from less use of medications was calculated at $28 to $32/person (each 3 months) using a capital base cost of $10,000 (for the SphygmoCor device), 5 years capital life, 5% discount rate, patient throughput of 50/year and, labour costs up to $250/hour. Therefore, a fee for service to measure central BP of approximately $30 could be both economically and financially justifiable. Conclusions. Management of hypertension using central BP has cost-savings relating to decreased medication and may be regarded as cost-neutral when factoring in a fee for central BP measurement.