Department of Social Medicine, School of Public Health Guangxi Medical University Nanning China.
Department of Cardiology, Kailuan General Hospital North China University of Science and Technology Tangshan China.
J Am Heart Assoc. 2024 Apr 16;13(8):e031578. doi: 10.1161/JAHA.123.031578. Epub 2024 Apr 2.
In 2009, a workplace-based hypertension management program was launched among men with hypertension in the Kailuan study. This program involved monitoring blood pressure semimonthly, providing free antihypertensive medications, and offering personalized health consultations. However, the cost-effectiveness of this program remains unclear.
This analysis included 12 240 participants, with 6120 in each of the management and control groups. Using a microsimulation model derived from 10-year follow-up data, we estimated costs, quality-adjusted life years (QALYs), life-years, and incremental cost-effectiveness ratios (ICERs) for workplace-based management compared with routine care in both the study period and over a lifetime. Analyses are conducted from the societal perspective. Over the 10-year follow-up, patients in the management group experienced an average gain of 0.06 QALYs with associated incremental costs of $633.17 (4366.85 RMB). Projecting over a lifetime, the management group was estimated to increase by 0.88 QALYs or 0.92 life-years compared with the control group, with an incremental cost of $1638.64 (11 301.37 RMB). This results in an incremental cost-effectiveness ratio of $1855.47 per QALY gained and $1780.27 per life-year gained, respectively, when comparing workplace-based management with routine care. In probabilistic sensitivity analyses, with a threshold willingness-to-pay of $30 765 per QALY (3 times 2019 gross domestic product per capita), the management group showed a 100% likelihood of being cost-effective in 10 000 samples.
Workplace-based management, compared with routine care for Chinese men with hypertension, could be cost-effective both during the study period and over a lifetime, and might be considered in working populations in China and elsewhere.
2009 年，凯伦研究在高血压男性中启动了一项基于工作场所的高血压管理计划。该计划包括每半月监测一次血压、提供免费降压药物和提供个性化健康咨询。然而，该计划的成本效益尚不清楚。
本分析纳入了 12240 名参与者，其中管理组和对照组各有 6120 人。使用源自 10 年随访数据的微模拟模型，我们估算了与常规护理相比，基于工作场所的管理在研究期间和一生中的成本、质量调整生命年（QALY）、生命年和增量成本效益比（ICER）。分析从社会角度进行。在 10 年的随访中，管理组患者平均获得 0.06 个 QALY，增量成本为 633.17 美元（4366.85 人民币）。预计在一生中，与对照组相比，管理组的 QALY 增加了 0.88，生命年增加了 0.92，增量成本为 1638.64 美元（11301.37 人民币）。与常规护理相比，这分别导致增量成本效益比为每获得一个 QALY 增加 1855.47 美元，每获得一个生命年增加 1780.27 美元。在概率敏感性分析中，以每 QALY 30765 美元（2019 年人均国内生产总值的 3 倍）的支付意愿阈值，管理组在 10000 个样本中有 100%的可能性在经济上有效。
与常规护理相比，基于工作场所的管理对中国高血压男性来说，在研究期间和一生中都可能具有成本效益，在中国和其他地方的工作人群中可能值得考虑。
