Abstract 3856: Cost-effectiveness of Impedance Cardiography Testing in Uncontrolled Hypertension
Background: Use of noninvasive hemodynamic monitoring with impedance cardiography (ICG) results in a greater blood pressure (BP) reduction in uncontrolled hypertensive patients. Our objective was to evaluate the short- and long-term cost-effectiveness of ICG testing in this population.
Methods: Our analysis was based on the results of the CONTROL trial of 164 patients randomized to a Standard Care Arm or ICG Care Arm for a three-month period. Systolic BP reduction was 8 mm Hg greater and diastolic BP reduction was 7 mm Hg greater with ICG Care from baseline to final. Short-term cost-effectiveness of ICG Care was evaluated as the incremental cost per incremental mm Hg reduced during the trial. Long-term cost-effectiveness was evaluated as incremental cost per quality-adjusted life-year (QALY) gained and was modeled over a ten-year period.
Results: The short-term cost-effectiveness of ICG Care was $20 per incremental mm Hg reduced for systolic BP and $23 per incremental mm Hg reduced for diastolic BP, compared to Standard Care costs of $36 per mm Hg reduced for systolic BP and $79 per mm Hg reduced for diastolic BP. In the long-term, ICG Care resulted in a cost savings of $476 per patient ($22,003 ICG Care - $22,479 Standard Care) and 0.109 incremental QALYs (7.964 ICG Care - 7.855 Standard Care), equating to -$4,371 per QALY gained. Sensitivity analysis resulted in a range of 0.191 to 0.054 QALYs gained at -$8,764 to $13,163 per QALY gained. Based on these QALYs, the number of patients needed to be treated with ICG to save one year of life ranges from 5.2 to 18.5.
Conclusion: The use of ICG testing to reduce BP in uncontrolled hypertensive patients is cost-effective from both a short- and long-term perspective.