The Pandora Project: Cost of hypertension from a general practitioner database

Aim: The Pandora Project is a longitudinal database - implemented by general practitioners since June 1997 in the Ravenna area (Italy) - providing information on patients with hypertension. Data from 1651 patients were followed up for 1 year in order to investigate the cost of hypertension. Only direct medical costs were considered in the perspective of the National Healthcare System. Findings: At enrolment, 552 patients were classified as normotensive, 1099 as hypertensive. After I year, among normotensive group, 352 patients remained normotensive and 200 became hypertensive; among hypertensive group, 323 patients became normotensive and 776 remained hypertensive. The average total cost per patient at follow-up was 779.59 Euros. About 46% of total cost was due to anti-hypertensive therapy, irrespective of the evolution of blood pressure levels registered, whilst other direct costs represented 54% of total patient cost in all cohorts. It is possible that co-morbidities play a significant role in this situation. Patient aged 80-89 years generate higher costs. Even if further investigation is needed on the burden of co-morbidity on a per-patient cost of hypertension, this work provides evidence that the average total cost per patient is likely to increase with age and co-morbidities.