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Potential cost-effectiveness of therapeutic drug monitoring in patients with resistant hypertension

  • Background: Nonadherence to drug therapy poses a significant problem in the treatment of patients with presumed resistant hypertension. It has been shown that therapeutic drug monitoring (TDM) is a useful tool for detecting nonadherence and identifying barriers to treatment adherence, leading to effective blood pressure (BP) control. However, the cost-effectiveness of TDM in the management of resistant hypertension has not been investigated. Results: In the age group of 60-year olds, TDM gained 1.07 QALYs in men and 0.97 QALYs in women at additional costs of (sic)3854 and (sic)3922, respectively. Given a willingness-to-pay threshold of (sic)35 000 per QALY gained, the probability of TDM being cost-effective was 95% or more in all age groups from 30 to 90 years. Results were influenced mostly by the frequency of TDM testing, the rate of nonresponders to TDM, and the magnitude of effect of TDM on BP. Conclusion: Therapeutic drug monitoring presents a potential cost-effective healthcare intervention in patients diagnosed with resistantBackground: Nonadherence to drug therapy poses a significant problem in the treatment of patients with presumed resistant hypertension. It has been shown that therapeutic drug monitoring (TDM) is a useful tool for detecting nonadherence and identifying barriers to treatment adherence, leading to effective blood pressure (BP) control. However, the cost-effectiveness of TDM in the management of resistant hypertension has not been investigated. Results: In the age group of 60-year olds, TDM gained 1.07 QALYs in men and 0.97 QALYs in women at additional costs of (sic)3854 and (sic)3922, respectively. Given a willingness-to-pay threshold of (sic)35 000 per QALY gained, the probability of TDM being cost-effective was 95% or more in all age groups from 30 to 90 years. Results were influenced mostly by the frequency of TDM testing, the rate of nonresponders to TDM, and the magnitude of effect of TDM on BP. Conclusion: Therapeutic drug monitoring presents a potential cost-effective healthcare intervention in patients diagnosed with resistant hypertension. Importantly, this finding is valid for a wide range of patients, independent of sex and age.zeige mehrzeige weniger

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Metadaten
Verfasserangaben:Oliver Chung, Wanpen Vongpatanasin, Klaus BonaventuraORCiDGND, Yair Lotan, Christian Sohns, Wilhelm HaverkampORCiDGND, Marc Dorenkamp
DOI:https://doi.org/10.1097/HJH.0000000000000346
ISSN:0263-6352
ISSN:1473-5598
Pubmed ID:https://pubmed.ncbi.nlm.nih.gov/25255395
Titel des übergeordneten Werks (Englisch):Journal of hypertension
Verlag:Lippincott Williams & Wilkins
Verlagsort:Philadelphia
Publikationstyp:Wissenschaftlicher Artikel
Sprache:Englisch
Jahr der Erstveröffentlichung:2014
Erscheinungsjahr:2014
Datum der Freischaltung:27.03.2017
Freies Schlagwort / Tag:cardiovascular diseases; cost and cost analysis; cost-benefit analysis; drug monitoring; hypertension; medication adherence; probability; risk assessment
Band:32
Ausgabe:12
Seitenanzahl:11
Erste Seite:2411
Letzte Seite:2421
Organisationseinheiten:Humanwissenschaftliche Fakultät / Strukturbereich Kognitionswissenschaften / Department Sport- und Gesundheitswissenschaften
Peer Review:Referiert
Name der Einrichtung zum Zeitpunkt der Publikation:Humanwissenschaftliche Fakultät / Institut für Sportmedizin und Prävention
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