Hypertension Screening ROI Model (Health System) Calculator
- Hypertension Screening ROI Model (Health System): Explanation and Clinical/Economic Context
This calculator estimates the financial return from implementing a systematic hypertension screening pathway across a health system. It follows a standard budget-impact/ROI framing: total discounted cost savings from major cardiovascular (CVD) events averted minus the total discounted costs of screening, confirmatory assessment, and antihypertensive treatment over a user-defined time horizon, divided by total costs to yield ROI. The epidemiologic core assumes a target adult population with specified coverage; among those screened, the true burden of hypertension is governed by prevalence, while case ascertainment depends on sensitivity and specificity of the screening approach and a confirmatory step for all screen-positives. Treatment initiation (uptake) and persistence (adherence) determine the effective treated cohort.
Event prevention is modeled using empirically derived relative risk reduction (RRR) from achieved systolic blood pressure (SBP) lowering. Contemporary meta-analyses demonstrate that each 5 mmHg decrease in SBP reduces the risk of major CVD events by about 10%; thus, the RRR used here is 1 − 0.90ΔSBP/5. Users supply a baseline annual major CVD event rate among untreated hypertensives; the model estimates events prevented among adherent treated patients, multiplies by the direct medical cost per event, and discounts across the horizon to compute savings. Costs include (i) screening once at program start, (ii) confirmatory assessment for all initial screen-positives, and (iii) annual treatment for the newly treated cohort across the horizon, discounted. The outputs include the net present value (NPV), ROI, and an approximate discounted break-even year.
Reference:
Thomas C, Lister J, et al. Cardiovascular Disease Prevention Return on Investment Tool: Technical report and exemplars. 2017–2018.
Ettehad D, et al. Lancet. 2016;388:591–600.
Rahimi K, et al. Lancet. 2021;398.
Canoy D, et al. Curr Hypertens Rep. 2022;24.
Arrieta A, et al. PLoS One. 2021;16:e0252701.
Tajeu GS, et al. Circ Cardiovasc Qual Outcomes. 2024.
Skowrońska A, et al. Kardiol Pol. 2024.
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