Incremental cost of treating hypertension in the United States

The objective of this study was to determine incremental direct cost of treating hypertension in the U.S. population using an incremental cost approach. Analysis of the 2001 Medical Expenditure Panel Survey (MEPS), a national probability survey containing data for healthcare utilization, expenditures, payment sources, and insurance coverage for the civilian non-institutionalized U.S. population, was conducted. Hypertensive patients were identified as those with a medical diagnosis for hypertension using International Classification of Diseases codes, patients who consumed hypertension related medical care services or treatments during 2001, patients who self-reported being diagnosed as having hypertension by their physician and patients who were prescribed an anti-hypertensive medication. Incremental cost of treating hypertension was estimated through least squares regression adjusting for age, gender, race, education, and co-morbidities using the Charlson co-morbidity index. Sample data were projected to the U.S. population and 95 percent confidence limits for estimates were calculated using the Taylor expansion method. Sample estimates projected to the population indicated that approximately 17.4 percent of individuals aged 18 years and above in the United States had hypertension. Total incremental annual direct costs for hypertension patients were estimated to be more than $54.0 billion after adjusting for demographics and co-morbidities, with mean incremental annual per capita direct cost for a hypertensive individual being $1,131. Resource utilization was significantly higher among hypertensive patients (p< 0.0001) in each of several medical care services examined including prescription medicines, inpatient visits, outpatient visits, emergency room visits, office-based medical provider visits, home health visits, and other medical expenses as compared to non-hypertensive patients. Prescription medicines, inpatient visits, and outpatient visits constituted more than 90 percent of the overall incremental cost of treating hypertension. With hypertension affecting approximately 17.4 percent of the population in the year 2001 and incremental direct medical costs estimated at nearly $55.0 billion for the year 2001, hypertension costs represent a significant economic burden.