Chia Nan University of Pharmacy & Science Institutional Repository:Item 310902800/34593
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    標題: 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
    作者: 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
    貢獻者: 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
    關鍵字: cost-effectiveness
    risk
    adherence
    日期: 2023
    上傳時間: 2023-12-11 13:59:36 (UTC+8)
    出版者: SPRINGERNATURE
    摘要: 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.
    關聯: HYPERTENSION RESEARCH, v.46, pp.187–199
    顯示於類別:[保健營養系(所) ] 期刊論文

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