Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, state of São Paulo, Brazil.
PLoS One. 2018 Mar 6;13(3):e0193567. doi: 10.1371/journal.pone.0193567. eCollection 2018.
Only 20% of patients with systemic arterial hypertension (SAH) have blood pressure within recommended parameters. SAH has been the main risk factor for morbidity and mortality of cardiovascular diseases, which affects the burden of the Public Health System (PHS). Some studies have shown the effectiveness of Pharmaceutical Care (PC) in the care of hypertensive patients.
To perform a cost-effectiveness analysis to compare SAH treatment with PC management and conventional treatment for hypertensive patients offered by the PHS.
A cost-effectiveness study nested to a quasi-experimental study was conducted, in which 104 hypertensive patients were followed up in a PC program. Blood pressure control was considered as the outcome for the economic analysis and the costs were direct and non-direct medical costs.
PC was dominant for two years in the post-PC period compared with the pre-PC year. The mean cost effectiveness ratio (CER) for the CERPre-PC, CERPC, and CERPost-PC periods were: US$ 364.65, US$ 415.39, and US$ 231.14 respectively. The incremental cost effectiveness ratio (ICER) analysis presented ICER of US$ 478.41 in the PC period and US$ 42.95 in the post PC period. Monte Carlo sensitivity analysis presented mean ICERPC and ICERPost-PC equal to US$ 605.09 and US$ 128.03, reaching US$ 1,725.00 and US$ 740.00 respectively.
Even for the highest ICER, the values were below the cost effectiveness threshold, which means that PC was a cost effective strategy for the care of hypertensive patients in the PHS.
仅有 20%的系统性动脉高血压（SAH）患者的血压处于推荐参数范围内。SAH 一直是心血管疾病发病率和死亡率的主要风险因素，这影响了公共卫生系统（PHS）的负担。一些研究表明，药物治疗（PC）在高血压患者的护理中是有效的。
进行成本效益分析，以比较 PH S 提供的 SAH 治疗与 PC 管理和常规治疗高血压患者的效果。
进行了一项嵌套在准实验研究中的成本效益研究，其中对 104 名接受 PC 方案的高血压患者进行了随访。将血压控制作为经济分析的结果，成本为直接和非直接医疗成本。
与 PC 前一年相比，PC 后两年具有优势。PC 前一年、PC 年和 PC 后一年的平均成本效益比（CER）分别为：364.65 美元、415.39 美元和 231.14 美元。增量成本效益比（ICER）分析显示 PC 期间的 ICER 为 478.41 美元，PC 后期间的 ICER 为 42.95 美元。蒙特卡罗敏感性分析显示 PC 期间的平均 ICERPC 和 PC 后期间的 ICERPost-PC 分别为 605.09 美元和 128.03 美元，分别达到 1725.00 美元和 740.00 美元。
即使是最高的 ICER，其值仍低于成本效益阈值，这意味着 PC 是 PHS 中高血压患者护理的一种具有成本效益的策略。
