Economic evaluation of new blood pressure target for hypertensive patients in Taiwan according to the 2022 hypertension clinical practice guidelines of the Taiwan society of cardiology: a simulation modeling study

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Title:	Economic evaluation of new blood pressure target for hypertensive patients in Taiwan according to the 2022 hypertension clinical practice guidelines of the Taiwan society of cardiology: a simulation modeling study
Authors:	Liao, Chia-Te Toh, Han Siong Yang, Chun-Ting Hsu, Chien-Yi Lee, Mei-Chuan Chang, Wei-Ting Chen, Zhih-Cherng Chang, Hung-Yu Strong, Carol
Contributors:	National Cheng Kung University Chi Mei Hospital KU Leuven Chi Mei Hospital National Cheng Kung University Chia Nan University of Pharmacy & Science,Department of Health and Nutrition National Cheng Kung University Taipei Medical University Taipei Medical University Taipei Medical University Taipei Medical University Chi Mei Hospital Cheng Hsin General Hospital National Yang Ming Chiao Tung University
Keywords:	cost-effectiveness risk adherence
Date:	2023
Issue Date:	2023-12-11 13:59:36 (UTC+8)
Publisher:	SPRINGERNATURE
Abstract:	With the promising cardiovascular benefits in the STEP and SPRINT trials, the 2022 Taiwan's hypertension guidelines redefined the hypertension threshold as 130/80 mmHg and a universal blood-pressure target of <130/80 mmHg. This study's objective was to examine the cost-effectiveness of the intensive blood-pressure target for hypertensive patients using estimated lifetime medical costs and quality-adjusted life years (QALY) from the Taiwan national payer's perspective. We developed a lifetime Markov model comparing the intensive and conservative blood-pressure targets. Incremental cost-effectiveness ratio (ICER) against the willing-to-pay thresholds at the one-time [US$34,000(NT$1,020,000)] and three-time [US$100,000(NT$3,000,000)] gross domestic product per capita were defined as very cost-effect and only cost-effective. The cost-effectiveness in different age stratifications and cardiovascular risks treated with a more intensive target (120 mmHg) were examined in the subgroup analyses. The new blood-pressure treatment target produced more lifetime medical costs [US$31,589(NT$947,670) versus US$26,788(NT$803,640)] and QALYs (12.54 versus 12.25), and the ICER was US$16,589(NT$497,670), which was 99.1% and 100% probability of a very cost-effective and cost-effective strategy. The ICERs in all age stratifications had more than a 90% probability of being very cost-effective, and ICERs decreased with age. More intensive control in patients with high cardiovascular risks produced a lower ICER [US$14,547(NT$436,410)]. In conclusion, Taiwan's new blood-pressure treatment target can prevent more cardiovascular events with acceptable costs per QALY below the willing-to-pay thresholds. The cost-effectiveness of intensive control is consistent across different ages and more pronounced with the increase in age and cardiovascular risk.
Relation:	HYPERTENSION RESEARCH, v.46, pp.187–199
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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