The European Journal of Health Economics

, Volume 12, Issue 3, pp 205–218 | Cite as

Modelling the costs of care of hypertension in patients with metabolic syndrome and its consequences, in Germany, Spain and Italy

  • Eberhard WilleEmail author
  • Jürgen Scholze
  • Eduardo Alegria
  • Claudio Ferri
  • Sue Langham
  • Warren Stevens
  • David Jeffries
  • Kerstin Uhl-Hochgraeber
Original Paper


The presence of metabolic syndrome in patients with hypertension significantly increases the risk of cardiovascular disease, type 2 diabetes and mortality. Our aim is to estimate the economic burden to the health service of metabolic syndrome (MetS) in patients with hypertension and its consequences, in three European countries in 2008, and to forecast future economic burden in 2020 using projected demographic estimates and assumptions around the growth of MetS. An age-, sex- and risk group-structured prevalence-based cost of illness model was developed using the United States Adult Treatment Panel III of the National Cholesterol Education Program criteria to define MetS. Data sources included published information and public use databases on disease prevalence, incidence of cardiovascular events, prevalence of type 2 diabetes, treatment patterns and cost of management in Germany, Spain and Italy. The economic burden to the health service of MetS in patients with hypertension has been estimated at 24,427 €, 1,900 € and 4,877 € million in Germany, Spain and Italy, and is forecast to rise by 59, 179 and 157%, respectively, by 2020. The largest components of costs included the management of prevalent type 2 diabetes and incident cardiovascular events. Mean annual costs per hypertensive patient were around three-fold higher in subjects with MetS compared to those without and rose incrementally with the additional number of MetS components present. In conclusion, the presence of MetS in patients with hypertension significantly inflates economic burden, and costs are likely to increase in the future due to an aging population and an increase in the prevalence of components of MetS.


Cost of illness Health care costs Prevalence Metabolic syndrome Hypertension 

JEL Classification

I11 I12 



This study was funded by Bayer Schering Pharma AG.


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Eberhard Wille
    • 1
    Email author
  • Jürgen Scholze
    • 2
  • Eduardo Alegria
    • 3
  • Claudio Ferri
    • 4
  • Sue Langham
    • 5
  • Warren Stevens
    • 6
  • David Jeffries
    • 7
  • Kerstin Uhl-Hochgraeber
    • 8
  1. 1.Fakultät für VolkswirtschaftslehreMannheimGermany
  2. 2.Department of Medicine, Outpatient Clinic, CCMCharite-Universitatsmedizin BerlinBerlinGermany
  3. 3.Servicio de CardiologíaPoliclínica GipuzkoaSan SebastiánSpain
  4. 4.Division of Internal Medicine, Hypertension and Cardiovascular Prevention Center, Department of Internal Medicine and Public Health, San Salvatore HospitalUniversity of L’AquilaL’AquilaItaly
  5. 5.Independent Health EconomistManchesterUK
  6. 6.Independent Health EconomistBostonUSA
  7. 7.Statistics and Data ManagementMRC Tropical Disease Research UnitBanjulGambia
  8. 8.Global Health Economics and Outcomes ResearchBayer Schering Pharma AGBerlinGermany

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