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National Estimate of Cost of Illness for Hypertension and Non-Persistence with Drug Therapy Using the Medical Expenditure Panel Survey

Graden, Suzanne
http://rave.ohiolink.edu/etdc/view?acc_num=osu1046972930

Abstract Details

2003, Doctor of Philosophy, Ohio State University, Pharmacy.
Hypertension is one of the most prevalent vascular diseases in the United States. In addition to being the major risk factor for stroke, hypertension is also a risk factor for many cardiovascular diseases. Although drug therapy for the treatment of hypertension is cost-effective, inadequate blood pressure control is common. The primary reason for this uncontrolled blood pressure is the individual not taking their medication as directed and/or discontinuing therapy. Data utilized for this research are from a national probability survey dataset, the Medical Expenditure Panel Survey for 1998. This research estimates the cost of illness for hypertension, incorporating both direct and indirect costs. In addition, estimates of the financial impact of non-persistence with drug therapy on the cost of illness are calculated. Lastly, statistical models are developed to quantify the risk associated with variables of interest and persistence with any hypertension drug. All statistical analyses utilize design-based methods. The estimated cost of illness for individuals with hypertension was $ 173 billion (se = $ 14.3 billion) in total direct medical expenditures and almost 16% (se = 1%) reported missing work. The cost of illness estimated for hypertension consisted of total direct medical costs of $ 21 billion (se = $ 4.3 billion). Non-persistence with drug therapy resulted in higher expenditures for total direct medical expenditures, hospital care, physician services, and home health care. Expenditures of individuals non-persistent were lower for prescription drugs and other medical care. Significant difference between persistent and non-persistent expenditures occurred for hospital care and prescription drugs (p-value < 0.05). Risk models developed for mail order pharmacy use did not produce significantly different risk estimates for persistence in comparison to not using mail order pharmacy services. When compared to private insurance, the difference in risk associated with persistence when utilizing public insurance was significantly lower. However, risk with private insurance compared to uninsured was not significantly different. Beta blockers, adrenergic agents and calcium channel blockers had significantly different risk for persistence with any hypertension drug when compared to diuretics and controlling for confounders. Non-significant differences in risk resulted for ACE inhibitors and ARBs when compared to diuretics.
Craig Pedersen (Advisor)
Health Sciences, Pharmacy
Hypertension; Cost of illness; Medical Expenditure Panel Survey; Persistence; Risk

Recommended Citations

Citations

  • Graden, S. (2003). National Estimate of Cost of Illness for Hypertension and Non-Persistence with Drug Therapy Using the Medical Expenditure Panel Survey [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1046972930

    APA Style (7th edition)

  • Graden, Suzanne. National Estimate of Cost of Illness for Hypertension and Non-Persistence with Drug Therapy Using the Medical Expenditure Panel Survey. 2003. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1046972930.

    MLA Style (8th edition)

  • Graden, Suzanne. "National Estimate of Cost of Illness for Hypertension and Non-Persistence with Drug Therapy Using the Medical Expenditure Panel Survey." Doctoral dissertation, Ohio State University, 2003. http://rave.ohiolink.edu/etdc/view?acc_num=osu1046972930

    Chicago Manual of Style (17th edition)

osu1046972930
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This open access ETD is published by The Ohio State University and OhioLINK.