OBJECTIVES: To determine the cost effectiveness of free anti-hypertensive drug intervention on HIV patients with hypertension.

1.To determine the impact of increased access to free-anti-hypertensive on median blood pressure.

2.To identify the factors associated with hypertension control among HIV patients receiving free-anti-hypertensive drugs.

3.To determine the cost per mm Hg reduction in blood pressure (BP).

METHODS : Information on the total cost of the intervention was extracted from IDI financial records. Data on blood pressure measurement was extracted from the IDI medical electronic database and matched with unit cost per prescribed medicine. The outcomes measured were systolic blood pressure (SBP) ≥140 mm Hg, diastolic blood pressure (DBP) ≥90 mm Hg of the participants, estimated from the random sample of 754 patients at the IDI clinic. For each participant in the sample, the blood pressure was measured 3 times before and after the intervention. The effectiveness of the treatment was defined as the value (in mm Hg) to which the intervention was able to reduce the patients' SBP and DBP. Thus, the intervention effectiveness was defined as: Intervention Effectiveness = Post-intervention BP – Pre-intervention BP

RESULTS:The total cost of implementing the intervention was $18,956 or $ 25.14 per participant. After the 1-year intervention, median SBP dropped by 2 mm Hg and the number of patients with controlled BP increased by 64 representing an 8.5% increment in the percentage of patients with controlled blood pressure. The reduction in controlled blood pressure was statistically significant (p< 0.001). Cost effectiveness ratio for SBP was $ 12.5 per person per mm Hg SBP and controlled BP was $ 0.571.

CONCLUSIONS :

Providing free anti-hypertensive drugs to HIV positive patients was effective in reducing BP thus reducing the overall risk of CVD events. The study provides preliminary evidence on the cost-effectiveness of providing free anti-hypertensive drugs in HIV clinics in Uganda.