OBJECTIVES: Hypertension accounts for more than 3% of medical care expenditure in Japan. A proper understanding of the financial impact of hypertension and hypertensive complications is important for appropriate allocation of healthcare resources. In this study, we analyzed the medical care expenditures of hypertension and hypertensive complications in Japan using claims data.

METHODS: Hospital-based claims data from the Medical Data Vison (MDV) database and out-of-hospital pharmacy prescription data from the IQVIA database from 2019 to 2021 were analyzed to estimate treatment costs for stroke, myocardial infarction (MI), heart failure (HF), and antihypertensive drugs. Episodes of care were identified using relevant ICD-10 diagnosis codes, procedure, medical device, and drug codes.

RESULTS: A total of 813,112 hypertensive patients were identified in the MDV data, with a mean age of 71.6 years and a male ratio of 52.5%. The sample included 25,877 acute stroke patients, with an average length of stay of 38.5 days and mean treatment costs during the first month of treatment of 2,408,761 JPY; in the 22,408 acute MI patients in the sample, the average length of stay was 16.5 days and mean treatment costs during the first month of treatment were 2,271,878 JPY; in the 59,928 HF patients in the sample, the average length of stay was 22.8 days and mean treatment costs (from admission to 365 days) were 2,293,542 JPY.

A total 5,747,025 patients prescribed antihypertensive drugs in 2021 were identified in the IQVIA data. Of these, 95.1% of patients were taking a single drug or a combination of two to three different classes of drugs, with total cost ranging from 5,521 to 21,801 JPY/month.

CONCLUSIONS: Based on this large and contemporary real-world study, hypertension and its complications present a substantial cost burden to the Japanese healthcare system.