Cost-effectiveness of implementing new guidelines for treatment of hypertension in general practice.

BACKGROUND: Hypertension is a major public health concern and, as the population ages, the size of the problem is likely to increase. However, detection rates and treatment of hypertension have been low. The introduction of new guidelines for the detection and treatment of hypertension have been encouraged but without any consideration to their cost-effectiveness. AIM: To assess the potential cost-effectiveness of implementing new guidelines for the treatment of hypertension in general practice. Design of study: Model examining the incremental costs and effects of the new guidelines compared with the old. SETTING: A large general practice in north Yorkshire. METHOD: Two thousand and twenty-three patients reporting for a new health patient check had the costs and outcomes under the old and new guidelines estimated. RESULTS: Implementing new guidelines for the detection, management, and treatment of hypertension in a primary care setting is more costly than the implementation of previous guidelines, but more effective in reducing the risk of cardiovascular disease. The incremental cost per cardiovascular disease event avoided is ?30 000, although sensitivity analysis shows that the estimate is subject to considerable uncertainty. CONCLUSIONS: Compared with previous guidelines, introducing new guidelines for the management and treatment of hypertension in new patients in general practice is likely to be cost-effective. However, the workforce implications for general practitioners (GPs) and practice nurses should be considered.