J Clin Hypertens (Greenwich). 2009;11:116–124. ©2009 Wiley Periodicals, Inc.
Hypertension is a costly disease; however, the investment needed for a cost-neutral hypertension management program (HMP) is unknown. A Markov decision analytic model simulated the outcomes of a hypothetical HMP. Patients were between the ages of 25 and 65 years, had existing hypertension, and were newly diagnosed with diabetes. The control group received standard care. The HMP group received standard care and were enrolled in an HMP. Data regarding rates of disease states and costs were gathered from the literature. A third-party payer can invest as much as $159, $109, and $41 per person per month in an HMP for a neutral return on investment in the 5-year, 3-year, and 1-year time horizon, respectively. The HMP group achieved greater gains in quality-adjusted life-years and lower total health-related costs. As the time horizon increases, more money can be invested. HMPs can be a cost-effective and cost-neutral proposition.