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VALUE INSTITUTE
Christiana Care researchers explore the cost vs. benefit of intensive blood-pressure treatment
Rigorous interventions to control blood pressure add months to a patient’s life without prohibitive health or financial
costs, according to a study co-authored by Christiana Care Health System scholars and published Aug. 24 in the New England Journal of Medicine (NEJM).
By connecting a health intervention with both cost-effectiveness and health benefits, the study helps Christiana Care and other health systems transition to value-based care, said Zugui Zhang, Ph.D., a lead biostatistician and Value Institute scholar, who co-authored the paper along with former Cardiology chief and researcher William Weintraub, M.D., MACC, FAHA, FESC.
The Systolic Blood Pressure Intervention Trial, or SPRINT, weighed the costs and benefits
of aggressive treatment of blood pressure. It took into account the financial cost of such treatment and the risks of serious side effects it might cause.
“By connecting a health intervention with both cost- effectiveness and health benefits, the study helps Christiana Care and other health systems transition to value-based care.”
Zugui Zhang, Ph.D.
The team’s findings amount to an endorsement of more intensive blood-pressure treatment
in the target population, which on average added more than three months of healthy
life compared with standard treatment. The financial cost of these benefits depends on assumptions about how long the effects of treatment persist, but, even if benefits decline after five years, each year of healthy life “costs” about $47,000. If the treatment retains its effectiveness over the patient’s entire life, its price would be $28,000 per year of healthy life.
An intervention that adds a year of perfect health at the price of no more than $50,000 would generally be considered cost-effective in the United States.
Instead of tracking individuals over time, the study’s authors constructed a hypothetical sample using data from an earlier SPRINT trial. Using these previous results, the team estimated the risk of death and serious adverse events in 10,000 hypothetical | CONTINUED
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