Author + information
- Jordan King,
- Brandon Bellows,
- Adam Bress,
- Natalia Ruiz-Negrón,
- Rachel Hess,
- Srinivasan Beddhu,
- Zugui Zhang,
- Dan Berlowitz,
- Andrew Moran and
- William Weintraub
Background: In the Systolic Blood Pressure Intervention Trial (SPRINT), patients with prior cardiovascular disease (CVD) at baseline experienced a smaller relative reduction in fatal or non-fatal CVD events with an intensive systolic blood pressure (SBP) goal <120 mmHg compared to a standard SBP goal <140 mmHg. The objective here was to estimate the cost-effectiveness of intensive vs. standard SBP goals in patients with a prior history of CVD from a US payer perspective.
Methods: A microsimulation model was created to estimate CVD events, severe adverse events (SAEs), quality-adjusted life years (QALYs), and direct healthcare costs of intensive vs. standard SBP goals in SPRINT-eligible US adults with prior CVD. CVD events and SAE risks were derived from SPRINT published results, and healthcare costs and utilities from national sources and published estimates. Uncertainty in lifetime treatment benefits, harms, and costs was assessed by varying treatment adherence over a lifetime.
Results: In all scenarios, an intensive SBP goal resulted in increased costs, survival and QALYs in SPRINT-eligible patients with prior CVD. The resulting incremental cost-effectiveness ratios ranged from $54,000 to $65,000 per QALY gained, and $40,000 to $47,000 per life year gained.
Conclusions: Most simulations found the cost per QALY to be below $100,000 for SPRINT-eligible patients with prior CVD. The estimates were dependent on model parameters, including persistence of blood pressure benefit after the trial period.
Moderated Poster Contributions
Prevention Moderated Poster Theater, Poster Hall, Hall C
Sunday, March 19, 2017, 12:30 p.m.-12:40 p.m.
Session Title: New Insights Into Prediction and Treatment of Hypertension
Abstract Category: 33. Prevention: Hypertension
Presentation Number: 1314M-03
- 2017 American College of Cardiology Foundation