Article

A previous economic analysis of self-management, that is,
self-monitoring with self-titration of antihypertensive medication evaluated
cost-effectiveness among patients with uncomplicated hypertension. This study
considered cost-effectiveness of self-management in those with raised blood
pressure plus diabetes, chronic kidney disease and/or previous cardiovascular disease. METHODS: A Markov model-based economic evaluation was
undertaken to estimate the long-term cost-effectiveness of self-management of
blood pressure in a cohort of 70-year-old 'high risk' patients, compared with
usual care. The model used the results of the TASMIN-SR trial. A cost-utility
analysis was undertaken from a UK health and social care perspective, taking into
account lifetime costs of treatment, cardiovascular events and quality adjusted
life years. A subgroup analysis ran the model separately for men and women.
Deterministic sensitivity analyses examined the effect of different time horizons
and reduced effectiveness of self-management. RESULTS: Base-case results
indicated that self-management was cost-effective compared with usual care,
resulting in more quality adjusted life years (0.21) and cost savings (-
pound830) per patient. There was a 99% chance of the intervention being
cost-effective at a willingness to pay threshold of pound20,000 per quality
adjusted life year gained. Similar results were found for separate cohorts of men
and women. The results were robust to sensitivity analyses, provided that the
blood pressure lowering effect of self-management was maintained for more than a
year. CONCLUSION: Self-management of blood pressure in high-risk people with
poorly controlled hypertension not only reduces blood pressure, compared with
usual care, but also represents a cost-effective use of healthcare resources.
CI - (c) The European Society of Cardiology 2015.

Langue : ANGLAIS