Cost-effectiveness of antihypertensive therapy: What message to patients, doctors and health services?

Alberto Zanchetti

Research output: Contribution to journalArticle

Abstract

Increasing attention is being paid to cost-effectiveness analyses of medical treatment as instruments for decision making, especially in medical conditions that are widely prevalent, such as arterial hypertension. Especially in young and middle-aged subjects with mild to moderate hypertension, the assessment of benefit is particularly difficult The current use of the results of randomized trials for these analyses underestimates treatment benefits, and overemphasizes the cost-effectiveness of antihypertensive treatment in the elderly while discouraging treatment of younger and uncomplicated hypertensive patients. On the other hand, the actuarial approach (i.e. calculation on the basis of actuarial tables of the number of life-years expected to be gained by normalizing blood pressure) suggests that more years of life can be gained by treating young and uncomplicated hypertensive patients, and that cost-effectiveness is better in these subjects. It must be recognized that much uncertainty remains concerning the calculation of the cost-effectiveness of antihypertensive treatment, and therefore well-balanced information and liberal advice is required rather than prescriptive and restrictive guidelines.

Original languageEnglish
JournalJournal of Hypertension, Supplement
Volume16
Issue number9
Publication statusPublished - 1998

Keywords

  • Antihypertensive therapy
  • Cost effectiveness assessment
  • Long-term benefits
  • Randomized trials
  • Short-term benefits

ASJC Scopus subject areas

  • Internal Medicine

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