Introduction: The current study was designed to calculate the direct cost of noncompliance of hypertensive patients to the US health system. Understanding these expenses can inform screening and education budget policy regarding expenditure levels that can be calculated to be cost-beneficial. Method: The study was conducted in 3 parts. First, a computer search of National Institutes of Health Web sites and professional society Web sites for organizations with members that treat hypertension, and a PubMed search were performed to obtain the numbers required for calculations. Second, formulas were developed to estimate the risk of noncompliance and undiagnosed hypertension. Third, risk calculations were performed using the information obtained in part 1 and the formulas developed in part 2. Results: Direct risk reduction for stroke caused by hypertension, heart attack, kidney disease, and heart disease was calculated for a 100% compliant strategy. Risk, case, and cost reduction for a 100% compliant strategy for hypertension were 32%, 8.5 million and US$ 72 billion, respectively. Discussion: Our analysis means that the society can spend up to the cost of noncompliance in screening, education, and prevention efforts in an attempt to reduce these costly and traumatic sequelae of poorly controlled hypertension in the light of published analysis.
Center for Diseases Control and Prevention, Diseases and Conditions Index—Heart Disease. Available athttp://www.cdc.gov/nchs/fastats/heart.htm. Accessed March 1, 2010.
4.
KannelWBSchwartzMJMcNamaraPM. Blood pressure and risk of coronary heart disease: the Framingham Study. 1969. Chest. 2009;136(5 suppl):e23.
5.
KnightELBohnRLWangPS. Predictors of uncontrolled hypertension in ambulatory patients. Hypertension. 2001;38:809–814.
KolanskyDM. Acute coronary syndromes: morbidity, mortality, and pharmacoeconomic burden. Am J Manage Care. 2009;15(2 suppl):S36–S41.
11.
HughesDABagustAHaycoxA. Accounting for noncompliance in pharmacoeconomic evaluations. Pharmacoeconomics. 2001;19(12):1185–1197.
12.
TaylorAA. Combination drug treatment of hypertension: have we come full circle?. Curr Cardiol Rep. 2004;6(6):421–426.
13.
BlouinJDragomirAFredetteM. Comparison of direct health care costs related to the pharmacological treatment of osteoporosis and to the management of osteoporotic fractures among compliant and noncompliant users of alendronate and risedronate: a population-based study. Osteoporos Int. 2009;20(9):1571–1581.
14.
NicholMBKnightTKWuJ. Transition probabilities and predictors of adherence in a California Medicaid population using antihypertensive and lipid-lowering medications. Value Health. 2009;12(4):544–550.
15.
PinskyBWTakemotoSKLentineKL. Transplant outcomes and economic costs associated with patient noncompliance to immunosuppression. Am J Transplant. 2009;9(11):2597–2606.
