Med Care

Objective:The objective of this study was to assess the potential health and budgetary impacts of implementing a pharmacist-involved team-based hypertension management model in the United States.Research Design:In 2017, we evaluated a pharmacist-involved team-based care intervention among 3 targeted groups using a microsimulation model designed to estimate cardiovascular event incidence and associated health care spending in a cross-section of individuals representative of the US population: implementing it among patients with: (1) newly diagnosed hypertension; (2) persistently ( 65 1 year) uncontrolled blood pressure (BP); or (3) treated, yet persistently uncontrolled BP\u2014and report outcomes over 5 and 20 years. We describe the spending thresholds for each intervention strategy to achieve budget neutrality in 5 years from a payer\u2019s perspective.Results:Offering this intervention could prevent 22.9\u201336.8 million person-years of uncontrolled BP and 77,200\u2013230,900 heart attacks and strokes in 5 years (83.8\u2013174.8 million and 393,200\u2013922,900 in 20 years, respectively). Health and economic benefits strongly favored groups 2 and 3. Assuming an intervention cost of $525 per enrollee, the intervention generates 5-year budgetary cost-savings only for Medicare among groups 2 and 3. To achieve budget neutrality in 5 years across all groups, intervention costs per person need to be around $35 for Medicaid, $180 for private insurance, and $335 for Medicare enrollees.Conclusions:Adopting a pharmacist-involved team-based hypertension model could substantially improve BP control and cardiovascular outcomes in the United States. Net cost-savings among groups 2 and 3 make a compelling case for Medicare, but favorable economics may also be possible for private insurers, particularly if innovations could moderately lower the cost of delivering an effective intervention.CC999999/ImCDC/Intramural CDC HHS/United States2020-11-01T00:00:00Z31567863PMC69139096986vault:3425