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Cost-effectiveness of hypertension therapy based on 2020 International Society of Hypertension guidelines in Ethiopia from a societal perspective

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  • Majid Davari
  • Mende Mensa Sorato
  • Abbas Kebriaeezadeh
  • Nizal Sarrafzadegan

Abstract

Introduction: There is inadequate information on the cost-effectiveness of hypertension based on evidence-based guidelines. Therefore, this study was conducted to evaluate the cost-effectiveness of hypertension treatment based on 2020 International Society of Hypertension (ISH) guidelines from a societal perspective. Methods: We developed a state-transition Markov model based on the cardiovascular disease policy model adapted to the Sub-Saharan African perspective to simulate costs of treated and untreated hypertension and disability-adjusted life-years (DALYs) averted by treating previously untreated adults above 30 years from a societal perspective for a lifetime. Results: The full implementation of the ISH 2020 hypertension guidelines can prevent approximately 22,348.66 total productive life-year losses annually. The incremental net monetary benefit of treating hypertension based was $128,520,077.61 US by considering a willingness-to-pay threshold of $50,000 US per DALY averted. The incremental cost-effectiveness ratio (ICER) of treating hypertension when compared with null was $1,125.44 US per DALY averted. Treating hypertension among adults aged 40–64 years was very cost-effective 625.27 USD per DALY averted. Treating hypertensive adults aged 40–64 years with diabetes and CKD is very cost-effective in both women and men (i.e., 559.48 USD and 905.40 USD/DALY averted respectively). Conclusion: The implementation of the ISH 2020 guidelines among hypertensive adults in Southern Ethiopia could result in $9,574,118.47 US economic savings. Controlling hypertension in all patients with or with diabetes and or CKD could be effective and cost-saving. Therefore, improving treatment coverage, blood pressure control rate, and adherence to treatment by involving all relevant stakeholders is critical to saving scarce health resources.

Suggested Citation

  • Majid Davari & Mende Mensa Sorato & Abbas Kebriaeezadeh & Nizal Sarrafzadegan, 2022. "Cost-effectiveness of hypertension therapy based on 2020 International Society of Hypertension guidelines in Ethiopia from a societal perspective," PLOS ONE, Public Library of Science, vol. 17(8), pages 1-23, August.
    • Handle: RePEc:plo:pone00:0273439
    DOI: 10.1371/journal.pone.0273439
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    References listed on IDEAS

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    1. Weinstein, M.C. & Coxson, P.G. & Williams, L.W. & Pass, T.M. & Stason, W.B. & Goldman, L., 1987. "Forecasting coronary heart disease incidence, mortality, and cost: The coronary heart disease policy model," American Journal of Public Health, American Public Health Association, vol. 77(11), pages 1417-1426.
    2. Dongfeng Gu & Jiang He & Pamela G Coxson & Petra W Rasmussen & Chen Huang & Anusorn Thanataveerat & Keane Y Tzong & Juyang Xiong & Miao Wang & Dong Zhao & Lee Goldman & Andrew E Moran, 2015. "The Cost-Effectiveness of Low-Cost Essential Antihypertensive Medicines for Hypertension Control in China: A Modelling Study," PLOS Medicine, Public Library of Science, vol. 12(8), pages 1-19, August.
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