Clinical and Cost-Effectiveness Analysis of Improved Blood Pressure Control in Hypertensive Patients with Type 2 Diabetes Mellitus

Samira Humaira Habib

Health Economics Unit, Diabetic Association of Bangladesh, Dhaka, N/A

Aims: The study was done to assess the cost-effectiveness of tight control of blood pressure in hypertensive diabetic patients, and to calculate the costing, cost analysis and assess the cost-effectiveness of the intended intervention. Incremental cost-effectiveness analysis and incremental cost per event-free year gained within the trial period of these patients was another objective.

Materials: A total of 200 hypertensive patients with type 2 diabetes undergoing treatment at the Cardiology OPD, BIRDEM and NHN were selected purposively in this cross-sectional study and were interviewed in March 2004 with a preset questionnaire along with scrutinization of guide book records regarding the direct cost (cost of medical advice, investigations, medical and other treatment) and indirect cost [travel cost, cost of productivity loss and accompanying person(s)]. Of them 100 were hypertensive patients with type 2 diabetes having uncontrolled blood pressure & ill-managed (BP>120/80 mm/Hg) and 100 were hypertensive patients with type 2 diabetes having controlled blood pressure & well-managed (BP< 120/80 mm/Hg). A comparison was made between these two groups. The incremental cost per event-free year gained within the trial period was also calculated.

Results: On comparing the two groups, the cost of uncontrolled group was found to be higher by US$ 6657.74 than that of controlled group. The incremental cost of intensive management (well-managed group) was US$178 (US$95 to US$232) per patient and event-free time gained in the intensive group was 0.55 (0.18 to 0.92) years and the lifetime gain was 1.19 (0.79 to 1.81) years. The incremental cost per event-free year gained was US$356 (costs and effects discounted at 6% a year) and US$198 (costs discounted at 6% a year and effects not discounted).

Conclusion: Timely management of patients with diabetic hypertension is both clinically beneficial and cost-effective. I