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The Cost Effectiveness of Hypertension Treatment in Sweden

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Summary

The aim of this study was to carry out an analysis of the cost effectiveness of antihypertensive drug treatment in different patient groups in Sweden. The cost effectiveness ratios were estimated as net costs (treatment costs minus reduced costs of cardiovascular morbidity) divided by the number of life-years gained (the increase in life expectancy). The analysis was based on the reduction of coronary heart disease and stroke in the most recent meta-analysis of antihypertensive treatment, to which Swedish cost data were applied.

We found that the cost per life-year gained decreases with age for both men and women. and is relatively low for middle-aged and older patients, even when the diastolic blood pressure (DBP) range is 90 to 94mm Hg. In conclusion. the results indicate that, in Sweden antihypertensive treatment is generally cost effective in middle-aged and older patients with a DBP of ≥Omm Hg. However. it is questionable whether it is generally cost effective to treat younger patients with mild hypertension.

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References

  1. Statistics Sweden. Statistical abstract of Sweden 1992. Stockholm: Statistics Sweden, 1991

  2. Kannel WB, Wolf PA, Garrison RJ, editor. The Framingham Study: an epidemiological investigation of cardiovascular disease, section 37: the probability of developing certain cardiovascular diseases in eight years at specified values of some characteristics. Springfield: US Department of Commerce National Technical Information Service, 1987

  3. Drummond MF, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. Oxford: Oxford Medical Publications, 1987

  4. Johannesson M, Jönsson S, Cost-effectiveness analysis of hypertension treatment a review of methodological issues. Health Policy 1991; 19: 55–78

    Article  PubMed  CAS  Google Scholar 

  5. Stason WB, Weinstein MC, Allocation of resources to manage hypertension. N Engl J Med 1971; 296: 732–9

    Article  Google Scholar 

  6. Edelson JT, Weinstein MC, Tosteson AN, et al. Long-term cost effectiveness of various initial monotherapies for mild to moderate hypertension. JAMA 1990: 263: 407–13

    Article  PubMed  CAS  Google Scholar 

  7. Littenberg B, Gamer AM, Sox HC. Screening for hypertension. Ann Intem Med 1990: 112: 192–202

    CAS  Google Scholar 

  8. Kawachi I, Malcolm LA. The cost-effectiveness of treating mild-to-moderate hypertension: a reappraisal. J Hypertens 1991; 9; 199–208

    Article  PubMed  CAS  Google Scholar 

  9. Johannesson M, Jönsson B. A review of cost-effectiveness analyses of hypertension treatment. Pharmacoeconomics 1992; 1: 250–64

    Article  PubMed  CAS  Google Scholar 

  10. Weinstein MC. Principles of cost-effective resource allocation in health care organizations. Am J Technol Assess Health Care 1990: 6: 93–103

    Article  CAS  Google Scholar 

  11. Weinstein MC, Stawn WB. Foundations of cost-effectiveness analysis for health and medical practices. N Engl J Med 1977: 296: 716–21

    Article  PubMed  CAS  Google Scholar 

  12. Johannesson M, Hedbrant J, Jönsson B. A computer simulation model for cost-effectiveness analysis of cardiovascular disease prevention. Med lnf 1991; 16: 355–62

    Article  CAS  Google Scholar 

  13. MacMahon S, Peto R, Cutler J, et al. Blood pressure, stroke and coronary heart disease. Part I. Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet 1990: 335: 765–74

    Article  PubMed  CAS  Google Scholar 

  14. Nilson P, Andersson DKG, Andersson P-E, et al. Cardiovascular risk factors in treated hypertensives: a nation-wide, cross-sectional study in Sweden. J Intern Med 1993: 233: 239–45

    Article  Google Scholar 

  15. Kannel WB, Wolf PA, Garrison RJ, editor. The Framingham study: an epidemiological investigation of cardiovascular disease. Section 35: survival following initial cardiovascular events, 30 year follow up. Springfield: US Department of Commerce National Technical lnformation Service, 1988

  16. Hbert PR, Moser M, Mayer J, et al. Recent evidence on drug therapy of mild to moderate hypertension and decrease in risk of coronary heart disease. Arch Inlern Med 1993: 153: 578–81

    Article  Google Scholar 

  17. Collins R, Peto R, MacMahon S, et al. Blood pressure, stroke and coronary heart disease, Part 2. Short term reductions in blood pressure: overview of randomised drug trials in their epidemiological context. Lancet 1990; 335: 827–38

    Article  PubMed  CAS  Google Scholar 

  18. Johannesson M, Borgquist L, Jönsson B. The costs of treating hypertension in Sweden: an empirical investigation in primary health care. Scand J Prim Health Care 1991; 9; 155–60

    Article  PubMed  CAS  Google Scholar 

  19. Nilsson P, Kandell-Collen A, Lindholm LH, et al. Care of hypertensives in Dalby: organization and health economic aspects. J Hum Hypertens 1993: 7: 551–4

    PubMed  CAS  Google Scholar 

  20. Olsson G, Levin L-A, Rehnqvisl N. Economic consequences of postinfarction prophylaxis with ß–blockers: cost–effectiveness of metoprolol. BMJ 1987; 294: 339–42

    Article  PubMed  CAS  Google Scholar 

  21. Levin L-A, Jönsson B. Cost–effectiveness of thrombolysis: a randomized study of intravenous rt–PA in suspected myocardial infarction. Eur Heart J 1992: 13: 2–8

    PubMed  CAS  Google Scholar 

  22. The Swedish Council on Technology Assessment in Health Care (SBU). Stroke. Stockholm: SBU, 1993

  23. Mills E, Thompson M, The economic costs of stroke in Massachusets, N Engl J Med 1978; 299: 415–8

    Article  PubMed  CAS  Google Scholar 

  24. Gerdtham U-G, Jönsson B, The impact of aging on health care expenditures in Sweden. Health Policy 1993: 24: 1–8

    Article  PubMed  CAS  Google Scholar 

  25. Discounting health care: only a matter of timing? [editorial]. Lancet 1992; 340: 148–9

  26. Lindgren B, Persson U, Hälsoindex: ett hjälpmedel för att styra sjukvardens resurser? Lakartidningen 1986: 83: 3260–5

    Google Scholar 

  27. Martens LL, Rutten FF, Erkelens DW. et al. Cost–effectiveness of cholesterol–Iowering therapy in the Netherlands. Am J Med 1989; 87 Suppl. 4A: 545–85

    Google Scholar 

  28. Tosteson AN, Rosenthal DI, Melton W, et al. Cost–effectiveness of screening perimenopausal white women for osteoporosis: bone densitometry and hormone replacement therapy. Ann Intern Med 1990: 113: 594–603

    PubMed  CAS  Google Scholar 

  29. Goldman L, Weinstein MC, Goldman PA, et al. Cost–effect iveness of HMG–COA reductase inhibition for primary and secondary prevention of coronary heart disease. JAMA 1991: 265: 1145–51

    Article  PubMed  CAS  Google Scholar 

  30. Hay JW, Wittels EH, Gotto AM. An economic evaluation of lovastatin for cholesterol lowering and coronary artery disease reduction. Am J Cardiol 1991; 67: 789–96

    Article  PubMed  CAS  Google Scholar 

  31. Johannesson M, Dahlöf B, Lindholm LH, et al. The cost–effectiveness of treating hypertension in elderly people: an analysis of the Swedish trial in old patients with hypertension (STOP Hypertension). J Intern Med 1993: 234: 317–23

    Article  PubMed  CAS  Google Scholar 

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  1. Centre for Health Economics, Stockholm School of Economics, Box 6501, S-113 83, Stockholm, Sweden

    Magnus Johannesson

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  1. Magnus Johannesson
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Johannesson, M. The Cost Effectiveness of Hypertension Treatment in Sweden. Pharmacoeconomics 7, 242–250 (1995). https://doi.org/10.2165/00019053-199507030-00008

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