Commentary to: Cost of poor adherence to anti-hypertensive therapy in five European countries
KeywordsBlood Pressure Cardiovascular Event Blood Pressure Control Outpatient Care Cost Implication
The study by Mennini et al.  uses a decision model to assess cost implications of improving adherence to medication in hypertensive patients in five European countries (England, France, Germany, Italy, and Spain) from a payer’s perspective over 10 years. To this end, the model predicts the 10-year risk for cardiovascular events based on the Framingham risk equation. In terms of costs, it considers drug and hospitalization costs. The model suggests savings through avoiding cardiovascular events in each of the five countries.
Absolute risk reduction of BP treatment = (probability of BP control∣BP treatment) × (absolute risk reduction∣BP control)
Net cost = 10-year cost of BP treatment − (absolute risk reduction of BP treatment) × (cost of hospitalization),
Hence, BP treatment in Italy leads to a net increase in costs. We obtain the same result for the other countries. Therefore, from the reading it is not clear how the authors came up with their finding of savings from adherence improvement. This result is also at odds with the results of cost-effectiveness analyses on BP treatment conducted in England and Germany using the Framingham risk equation as well: they did not show savings except for the treatment of high-risk patients [2, 3].
- 1.Mennini, F.S., Marcellusi, A., von der Schulenburg, J.M., Gray, A., Levy, P., Sciattella, P., Soro, M., Staffiero, G., Zeidler, J., Maggioni, A., Schmieder, R.E.: Cost of poor adherence to anti-hypertensive therapy in five European countries. Eur J Health Econ 16(1), 65–72 (2015)CrossRefPubMedGoogle Scholar