Modeling the Health and Budgetary Impacts of a Team-based Hypertension Care Intervention That Includes Pharmacists

Details

• Alternative Title:
  Med Care
• Personal Author:
  Overwyk, Katherine J. ; Dehmer, Steven P. ; Roy, Kakoli ; Maciosek, Michael V. ; Hong, Yuling ; Baker-Goering, Madeleine M. ; Loustalot, Fleetwood ; Singleton, Christa-Marie ; Ritchey, Matthew D.
• Description:
  Objective:
  
  The objective of this study was to assess the potential health and budgetary impacts of implementing a pharmacist-involved team-based hypertension management model in the United States.
  
  Research Design:
  
  In 2017, we evaluated a pharmacist-involved team-based care intervention among 3 targeted groups using a microsimulation model designed to estimate cardiovascular event incidence and associated health care spending in a cross-section of individuals representative of the US population: implementing it among patients with: (1) newly diagnosed hypertension; (2) persistently (≥ 1 year) uncontrolled blood pressure (BP); or (3) treated, yet persistently uncontrolled BP—and report outcomes over 5 and 20 years. We describe the spending thresholds for each intervention strategy to achieve budget neutrality in 5 years from a payer’s perspective.
  
  Results:
  
  Offering this intervention could prevent 22.9–36.8 million person-years of uncontrolled BP and 77,200–230,900 heart attacks and strokes in 5 years (83.8–174.8 million and 393,200–922,900 in 20 years, respectively). Health and economic benefits strongly favored groups 2 and 3. Assuming an intervention cost of $525 per enrollee, the intervention generates 5-year budgetary cost-savings only for Medicare among groups 2 and 3. To achieve budget neutrality in 5 years across all groups, intervention costs per person need to be around $35 for Medicaid, $180 for private insurance, and $335 for Medicare enrollees.
  
  Conclusions:
  
  Adopting a pharmacist-involved team-based hypertension model could substantially improve BP control and cardiovascular outcomes in the United States. Net cost-savings among groups 2 and 3 make a compelling case for Medicare, but favorable economics may also be possible for private insurers, particularly if innovations could moderately lower the cost of delivering an effective intervention.
  
  
• Subjects:
  Article Blood Pressure Cardiovascular Cost And Cost Analysis Disease Economics Hypertension Medicaid Medicare Patient Care Team Pharmacist

  More +
• Source:
  Med Care. 57(11):882-889
• Pubmed ID:
  31567863
• Pubmed Central ID:
  PMC6913909
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHS/United States
• Volume:
  57
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:dac09df3e6a0c15bb7260e927f9e130394097a194624bfabede195415fdf1845
• Download URL:
  https://stacks.cdc.gov/view/cdc/83580/cdc_83580_DS1.pdf
• File Type:
  [PDF - 358.27 KB ]