THE COST-EFFECTIVENESS OF A CARDIOVASCULAR MULTIPLE-RISK-FACTOR INTERVENTION PROGRAM IN TREATED HYPERTENSIVE MEN

Objectives. The aim of this study was to carry out a cost-effectiveness analysis of a multifactorial intervention programme in treated hypertensive patients. Design. A cost-effectiveness analysis based on 3 years of follow-up in an open, randomized, parallel-group study with allocation either to a comprehensive, multiple-risk-factor modification programme or to conventional treatment. Setting. An outpatient clinic of a city hospital. Subjects. Inclusion criteria were: male sex, age 50-72 (mean 66.4) years, treated hypertension and at least one of the following: serum cholesterol greater than or equal to 6.5 mmol L(-1), and/or smoking and/or diabetes mellitus. A total of 508 patients were included in the study. Interventions. Advice given to individuals, and group meetings based on nutritional advice and behavioural treatment principles. If necessary, drug therapy could be instituted to achieve the treatment goals in the intervention group: serum total cholesterol of < 6.0 mmol L(-1), no smoking, HbAl(c) < 6.0% and diastolic blood pressure < 90 mmHg in both groups. Main outcome measure. Incremental cost per life-year gained of the intervention programme. Results. The cost per life-year gained was SEK 4000 in an estimation based on the observed risk reduction and ranged between SEK 62000 and SEK 163000 in three estimations based on the risk factor changes. Conclusions. The analysis indicates that the intervention programme is cost-effective in the studied patient population.