A cost-effectiveness analysis of the Chronic Disease Management Program in patients with hypertension in Korea.

Abstract

The Chronic Disease Management Program (CDMP) of Korea has been introduced to improve care continuity in patients with hypertension and diabetes. This study evaluated the cost effectiveness of the CDMP in patients with hypertension from the perspective of the healthcare payer. A cost-effectiveness analysis was performed based on a Markov simulation model. The cost and effect of the CDMP versus usual care was compared in individuals aged 40 years or above. The two strategies were presumed to result in a difference in the incidence of myocardial infarction, stroke, and chronic kidney disease. The model was analyzed over the lifetime of the cohort. Incremental cost-effectiveness ratio (ICER) was calculated by dividing the difference in lifetime costs by the difference in lifetime effects (quality adjusted life years, QALYs) between the two strategies. Costs were expressed in Korean Won (KRW). The ICER value of the CDMP participation strategy was -5 761 088 KRW/QALY compared to usual care. Similar tendencies were found when limiting the population to only clinic users (-3 843 355 KRW/QALY) and national health examination participants (-5 595 185 KRW/QALY). The CDMP was highly cost-effective in patients with hypertension aged 40 years or above. Implementing efficient policies that enhance care coordination and improve outcomes in patients with hypertension is important.