LONG-TERM DEMENTIA RISK REDUCTION MAY IMPROVE THE COST-EFFECTIVENESS OF BLOOD PRESSURE LOWERING INTERVENTIONS INCLUDING RENAL DENERVATION
Author(s)
Anne M. Ryschon, MA1, Giovanni De Maria, MD2, Jan Benjamin Pietzsch, PhD1.
1Wing Tech Inc., Menlo Park, CA, USA, 2John Radcliffe Hospital, Oxford, United Kingdom.
1Wing Tech Inc., Menlo Park, CA, USA, 2John Radcliffe Hospital, Oxford, United Kingdom.
OBJECTIVES: This analysis explored the health-economic impact of dementia-risk reduction resulting from improved hypertension (HTN) management achieved with interventions such as renal denervation (RDN).
METHODS: A decision-analytic Markov model for the UK health system was utilized in an exploratory analysis to project dementia incidence, costs, and quality-adjusted life years (QALY) over lifetime for a cohort (age 55 years, 19.9% female) with uncontrolled HTN compared to a treatment group with maintained systolic blood pressure (SBP) reductions of 5-10 mmHg over lifetime. Cohort survival and dementia risk were informed by age- and sex-specific data for England. The relationship between change in BP and dementia risk was determined from published literature, however, long-term data are lacking. Costs) and utilities were specific to dementia severity, sourced from published literature, and discounted at 3.5% per annum. Analyses were conducted from both the healthcare payer and societal perspective. Sensitivity analyses were performed.
RESULTS: Over lifetime, the cumulative projected dementia risk was 58.8%. A maintained reduction in SBP, ranging from 5-10 mmHg, corresponded to 2.9-5.8% reductions in absolute dementia risk over lifetime. The decrement in quality-of-life (utility) in patients with dementia was 0.24. Under the base case assumptions, a 5- and 10-mmHg BP reduction corresponded to lifetime cost-savings of £156 and £899, and £314 and £1,806 from the payer and societal perspectives, and a QALY gain of 0.012 and 0.024, respectively. Projected cost-savings and QALY gain ranged from £75-1,138 and 0.002-0.006 and £150-2,287 and 0.005-0.012, for a 5- and 10-mmHg reduction. These added benefits can be expected to further improve the cost-effectiveness of RDN.
CONCLUSIONS: Reductions in dementia risk resulting from improved BP control may provide meaningful additional health economic value, particularly at the population level, that have not been routinely captured in cost-effectiveness analyses of BP lowering interventions including RDN. Further research is warranted to confirm these exploratory findings.
METHODS: A decision-analytic Markov model for the UK health system was utilized in an exploratory analysis to project dementia incidence, costs, and quality-adjusted life years (QALY) over lifetime for a cohort (age 55 years, 19.9% female) with uncontrolled HTN compared to a treatment group with maintained systolic blood pressure (SBP) reductions of 5-10 mmHg over lifetime. Cohort survival and dementia risk were informed by age- and sex-specific data for England. The relationship between change in BP and dementia risk was determined from published literature, however, long-term data are lacking. Costs) and utilities were specific to dementia severity, sourced from published literature, and discounted at 3.5% per annum. Analyses were conducted from both the healthcare payer and societal perspective. Sensitivity analyses were performed.
RESULTS: Over lifetime, the cumulative projected dementia risk was 58.8%. A maintained reduction in SBP, ranging from 5-10 mmHg, corresponded to 2.9-5.8% reductions in absolute dementia risk over lifetime. The decrement in quality-of-life (utility) in patients with dementia was 0.24. Under the base case assumptions, a 5- and 10-mmHg BP reduction corresponded to lifetime cost-savings of £156 and £899, and £314 and £1,806 from the payer and societal perspectives, and a QALY gain of 0.012 and 0.024, respectively. Projected cost-savings and QALY gain ranged from £75-1,138 and 0.002-0.006 and £150-2,287 and 0.005-0.012, for a 5- and 10-mmHg reduction. These added benefits can be expected to further improve the cost-effectiveness of RDN.
CONCLUSIONS: Reductions in dementia risk resulting from improved BP control may provide meaningful additional health economic value, particularly at the population level, that have not been routinely captured in cost-effectiveness analyses of BP lowering interventions including RDN. Further research is warranted to confirm these exploratory findings.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE310
Topic
Economic Evaluation
Topic Subcategory
Novel & Social Elements of Value
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)