Cost-utility analysis of a national project to reduce hypertension in Israel

Chaim Yosefy,Gary Ginsberg,Dror Dicker,Dov Gavish,Reuven Viskoper

doi:10.1186/1478-7547-5-16

Abstract

BackgroundThis study aims to calculate the health effects and costs of a proposed national hypertension prevention and control program.MethodsInterventions are based on experience from our two programs: 10-year period of Ashkelon Hypertension Detection and Control Program (AHDC Program) and the Israel Blood Pressure Control (IBPC) program. The costs of a nationwide program were calculated based on economic data, training staff levels, course frequency and unit costs.ResultsOver the next 20 years, the program should decrease the risk in one-half of the treated hypertensive cases of the following ailments: cardiovascular events such as Acute Myocardial Infarction (AMI) and Unstable Angina Pectoris (UAP) by 16.0%, stroke by 41.2%, End stage renal disease (ESRD) by 50.0% and peripheral vascular disease (PVD) by 42.6%. In total, around 2,242 lives, 35,117 years of life or 24,433 disability adjusted life years will be saved due to decreased mortality.Program costs amount to $352.7 million. However savings ($537.6 million), from reduced medical treatment ($444.3 million) and reduced pharmaceutical use ($93.3 million) as a result of morbidity decreases, exceed costs by $185.0 million.ConclusionThe project which saves both lives and resources should be extended nation-wide to reach as wide a population as possible.

Highlights

This study aims to calculate the health effects and costs of a proposed national hypertension prevention and control program
Israel Blood Pressure Control (IBPC) program The IBPC program was initiated in the year 2000. in this survey, we included patients from 30 general practice clinics across Israel, directed by specialists in family medicine, each seeing 1000–5000 patients
Around half of the estimated total of 2,242 fewer deaths will be due to the reduction in cerebrovascular strokes (1,114 fewer deaths), while there will be 543 fewer deaths from Acute Myocardial Infarction (AMI), 440 fewer deaths from End stage renal disease (ESRD) and 145 fewer deaths from Unstable Angina Pectoris (UAP) (Table 2)

Summary

Introduction

This study aims to calculate the health effects and costs of a proposed national hypertension prevention and control program. Cardiovascular (CV) risk factors such as hypertension, hyperlipidemia and diabetes, are insufficiently managed, according to current guidelines [1] This mismanagement occurs in spite of the accepted fact that reaching the recommended target goals of the various guidelines is an effective means to reduce morbidity and mortality from atherosclerosis and vascular events [2,3]. After 1 year of intervention in 4848 patients according to our method [10], there was a significant increase in control of risk factors In hypertension this percentage raised from 29.0 to 46.7%, in control of body weight from 36.7 to 43.8%, in Low Density Lipoprotein (LDL) levels from 31.2 to 41.7% while the percentage of patients with glucose levels above 200 mg/dl dropped from 5.2 to 3.1%. This study was initiated to help attain this goal and convince the health authorities, by presenting the costs and the utilities if the Ashkelon project were to be extended nationwide

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Conclusion