Cost-effectiveness issues in hypertension control.

In recent years, significant attention has been directed to the economics of health care. Pressures continue to mount to evaluate the cost-effectiveness of treating specific conditions and of utilizing specific treatment regimens. It has been demonstrated that the treatment of hypertension is very cost-effective. In fact, the total cost of hypertensive medication is more than offset by the savings from stroke alone. There is significant underidentification of hypertensive patients and therefore underprescribing of antihypertensive medications. Better identification would involve increased medication costs, but these should be more than offset by reduced hospital costs, improved productivity and enhanced quality of life. In selecting antihypertensive agents, particular attention should be given to the use of regimens that facilitate patient compliance. Once- or twice-a-day formulations, even when they are more expensive than formulations given three or four times daily, can result in lower overall treatment costs due to greater rates of compliance, better hypertension control and less use of physician, hospital and laboratory services.