Direct Costs of Hypertension Treatment in Iran
Abstract
Background: Hypertension is a common public health problem with potentially serious consequences. We aimed to explore the direct costs of hypertension treatment in Iran.
Methods: Literature review and STEPS survey were used to estimate the incidence and prevalence of hypertension for Iranian males and females and the proportion of its treatment coverage in 2020. A standard national protocol for hypertension treatment was used to estimate the required medical services including visits, medications, and lab tests. The cost of each service and the total cost of the disease were identified using the national reference costs.
Results: About 23.39 million people suffer from moderate systolic blood pressure (BP of 120 to 139 mm/Hg) and a further 14.6 million people had severe BP (≥140 mm/Hg). Nearby 39.8% of these patients, receive BP treatment. The direct costs of hypertension treatment were 19,006.08 billion IR Rials (USD 87.54 million), of which 16.60% and 83.40% of the costs were related to new and prior cases, respectively. The costs of patient visits, medications, and lab tests were 56%, 35.51%, and 8.49% of the total costs, respectively.
Conclusion: The prevalence and economic burden of hypertension are relatively high in Iran. Early detection and treatment of hypertension might have a significant effect on reducing its complications and costs.
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37. Hodgson TA, Cai L (2001). Medical care expenditures for hypertension, its complications, and its comorbidities. Med Care, 39(6):599-615.
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39. Costa JSDd, Fuchs SC, Olinto MTA, et al (2002). Cost-effectiveness of hypertension treatment: a population-based study. Sao Paulo Med J, 120(4):100-104.
40. Johannesson M, Jönsson B (1992). A review of cost-effectiveness analyses of hypertension treatment. Pharmacoeconomics, 1(4):250-264.
41. Rosendaal NT, Hendriks ME, Verhagen MD, et al (2016). Costs and cost-effectiveness of hypertension screening and treatment in adults with hypertension in rural Nigeria in the context of a health insurance program. PLoS One, 11(6):e0157925.
42. Moran AE, Odden MC, Thanataveerat A, et al (2015). Cost-effectiveness of hypertension therapy according to 2014 guidelines. N Engl J Med, 372:447-455.
2. Vos T, Abajobir AA, Abate KH, et al (2017). Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet, 390(10100):1211-1259.
3. Hay SI, Abajobir AA, Abate KH, et al (2017). Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet, 390(10100):1260-1344.
4. Bloom DE, Cafiero E, Jané-Llopis E, et al (2012). The global economic burden of noncommunicable diseases. Program on the Global Demography of Aging. https://www.hsph.harvard.edu/pgda/wp-content/uploads/sites/1288/2013/10/PGDA_WP_87.pdf
5. Lim SS, Vos T, Flaxman AD, et al (2012). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 380(9859):2224-2260.
6. Stevens G, Mascarenhas M, Mathers C (2009). Global health risks: progress and challenges. SciELO Public Health, https://apps.who.int/iris/handle/10665/270525
7. Collaborators GRF (2018). Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 392(10159):1923-94.
8. Forouzanfar MH, Liu P, Roth GA, et al (2017). Global burden of hypertension and systolic blood pressure of at least 110 to 115 mm Hg, 1990-2015. JAMA, 317(2):165-182.
9. Wang G, Grosse SD, Schooley MW (2017). Conducting research on the economics of hypertension to improve cardiovascular health. Am J Prev Med, 53(6 Suppl 2):S115-S117.
10. Whelton PK (1994). Epidemiology of hypertension. Lancet , 344(8915):101-106.
11. Kearney PM, Whelton M, Reynolds K, et al (2005). Global burden of hypertension: analysis of worldwide data. Lancet, 365(9455):217-223.
12. Mills KT, Stefanescu A, He J(2020). The global epidemiology of hypertension. Nature Rev Nephrol, 16(4), 223-237.
13. Zhou B, Bentham J, Di Cesare M, et al (2017). Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19• 1 million participants. Lancet, 389(10064):37-55.
14. MacMahon S, Peto R, Collins R, et al (1990). Blood pressure, stroke, and coronary heart disease: part 1, prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet, 335(8692):765-774.
15. Collaboration APCS (2003). Blood pressure and cardiovascular disease in the Asia Pacific region. J Hypertens, 21(4):707-716.
16. Forouzanfar MH, Afshin A, Alexander LT, et al (2016). Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet, 388:1659-1724.
17. Michaud CM, Murray CJ, Bloom BR (2001). Burden of disease—implications for future research. JAMA, 285(5):535-539.
18. Mathers CD, Loncar D (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med, 3(11):e442.
19. Non-Communicable Diseases Research Center, STEPS survey, Prevalence of hypertension[online];2016. Available from: https://vizit.report/panel/steps/fa/main.html#/forestLocation.
20. Hosseini M, Yaseri M, Asady H, et al (2019). Prevalence of high blood pressure in Iranian adults based on the 2017 ACC/AHA guideline. Med J Islam Repub Iran, 33:26.
21. Najafipour H, Nasri HR, Rostamzadeh F, et al (2020). Prevalence and incidence of pre-hypertension and hypertension (awareness/control) in Iran: findings from Kerman coronary artery diseases risk factors study 2 (KERCADRS). J Hum Hypertens,1-12.
22. Statistical Center of Iran, Iran's population [online];2020. Available from:https://www.amar.org.ir.
23. Non-Communicable Diseases Research Center, STEPS survey, High blood pressure coverage [online]. 2016. Available from: https://vizit.report/
24. Vice-Chancellor for Health TUoMSaHS, in collaboration with the Policy Research and Development Secretariat of Tehran University of Medical Sciences and Health Services (2016). Clinical guideline for dealing with high blood pressure. ed. Pune, tehran.
25. Valizadeh G, Bizhani M, Bahramali E, Kouhpayeh SA (2014). Investigating the consistancy rate of hypertension treatment through guide line JNC-7, in patients who were referred to health centers and health houses of Fasa University of Medical Sciences 2012. Journal of Fasa University of Medical Sciences, 4:74-80.
26. National Formulary of Iran [online]. Available from: http://irc.fda.gov.ir/nfi?Length=3.
27. Secretariat of the Supreme Council of Health Insurance, Tariffs and relative value of health services [online];2020. Available from: https://shora.behdasht.gov.ir.
28. Central Bank system, exchange rate [online];2020. Available from:https://fxmarketrate.cbi.ir/.
29. Esteghamati A, Abbasi M, Alikhani S, et al (2008). Prevalence, awareness, treatment, and risk factors associated with hypertension in the Iranian population: the national survey of risk factors for noncommunicable diseases of Iran. Am J Hypertens, 21(6):620-626.
30. Odell TW, Gregory MC (1995). Cost of hypertension treatment. J Gen Intern Med, 10(12):686-688.
31. Oyando R, Njoroge M, Nguhiu P, et al (2019). Patient costs of hypertension care in public health care facilities in Kenya. Int J Health Plann Manage, 34(2):e1166-e1178.
32. Cohen JD (2009). Hypertension epidemiology and economic burden: refining risk assessment to lower costs. Managed , 18(10):51-58.
33. Organization WHO (2002). The world health report 2002: reducing risks, promoting healthy life. ed. World Health Organization.
34. He FJ, MacGregor GA (2010). Reducing population salt intake worldwide: from evidence to implementation. Prog Cardiovasc Dis, 52(5):363-382.
35. Mills KT, Bundy JD, Kelly TN, et al (2016). Global disparities of hypertension prevalence and control: a systematic analysis of population-based studies from 90 countries. Circulation, 134(6):441-450.
36. Graden S (2003). National estimate of cost of illness for hypertension and non-persistence with drug therapy using the medical expenditure panel survey. The Ohio State University.
37. Hodgson TA, Cai L (2001). Medical care expenditures for hypertension, its complications, and its comorbidities. Med Care, 39(6):599-615.
38. Arredondo A, Zúñiga A (2006). Epidemiologic changes and economic burden of hypertension in Latin America: evidence from Mexico. Am J Hypertens, 19(6):553-559.
39. Costa JSDd, Fuchs SC, Olinto MTA, et al (2002). Cost-effectiveness of hypertension treatment: a population-based study. Sao Paulo Med J, 120(4):100-104.
40. Johannesson M, Jönsson B (1992). A review of cost-effectiveness analyses of hypertension treatment. Pharmacoeconomics, 1(4):250-264.
41. Rosendaal NT, Hendriks ME, Verhagen MD, et al (2016). Costs and cost-effectiveness of hypertension screening and treatment in adults with hypertension in rural Nigeria in the context of a health insurance program. PLoS One, 11(6):e0157925.
42. Moran AE, Odden MC, Thanataveerat A, et al (2015). Cost-effectiveness of hypertension therapy according to 2014 guidelines. N Engl J Med, 372:447-455.
| Files | ||
| Issue | Vol 52 No 9 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v52i9.13579 | |
| Keywords | ||
| Direct costs Hypertension Iran Non-communicable diseases | ||
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How to Cite
1.
Zamandi M, Daroudi R, Akbari Sari A. Direct Costs of Hypertension Treatment in Iran. Iran J Public Health. 2023;52(9):1973-1983.
