Treating Australia's high blood pressure problem comes at a high annual cost of more than AUD1.2 billion, with patients covering 40 per cent of the bill in out-of-pocket charges, and the taxpayer footing the remaining 60 per cent through government subsidies and industry contracts, says a new analysis by The George Institute for Global Health published today in Medical Journal of Australia.1
Over half the cost (51 per cent/$611 million) was pharmacy fees for dispensing and handling medications, with GP appointments and purchasing medicines from manufacturers costing $342M (29 per cent) and $221M (18 per cent) respectively during financial year 2021/22.
High blood pressure is still the leading risk factor for death in Australia, as it is a leading cause of heart attacks and stroke.2 With no symptoms, high blood pressure often goes undetected, yet is readily treated with medication, and diet and lifestyle improvements. Reducing the rate by 24 per cent could save about 37,000 lives annually.3
"As Australia struggles with a hypertension crisis, our analysis provides a real-world snapshot of the scale of spending on the problem, and who exactly is footing the bill, to help decision-makers develop more affordable, equitable and innovative pathways to get the problem under control," said lead author Professor Anthony Rodgers, Professional Fellow in the Cardiovascular Program at The George Institute for Global Health, and Conjoint Professor of Global Health at UNSW Sydney.
"Two things struck us immediately: how much of the cost is going through pharmacy, and that patients are carrying an unfair share of the overall burden," he noted.
"While our concession system helps some consumers, these are real costs for people on lower incomes. Many are living with other health problems too and would face difficult choices about what medicines or health appointments they can afford. This puts their health at risk and is a fundamental barrier to Australia achieving better blood pressure control and avoiding the serious and more costly health problems down the track," Prof. Rodgers said.
The estimates predate the 60-day prescribing program introduced by the Australian Government in 2023, "but we understand uptake has been slow so far, so patients aren't yet receiving the full benefit," he said. "Our data highlights a need for further policy interventions to reduce patients' out-of-pocket expenses."
Silent killer: high blood pressure still stalks Australians
Around 34 per cent of Australian adults are estimated to have high blood pressure but only half of these people are aware they have it, with the lack of widespread screening a major factor.4
About 1 in 3 (32 per cent) have managed to keep their blood pressure in a healthy range, well below similar economies like Canada, where the rate of control is 2 in 3 (68 per cent).5
Australia's National Hypertension Taskforce, which is hosting the first National Hypertension Summit in Sydney, has a goal to improve control rates from 32 per cent to 70 per cent by 2030.6
"Refocusing on ways to increase detection of high blood pressure, support better management in primary care, and finding better methods to help patients stay on therapy are all needed, but it's also critical to ensure that the costs are fair and sustainable," Prof. Rodgers said.
"Our research sends a clear message to decision makers that we can and must improve health policy to reduce preventable deaths from heart attack, stroke and kidney disease in Australia."
To estimate expenditure on hypertension diagnosis and treatment by source of funding, researchers used publicly available data from the Pharmaceutical Benefits Scheme (PBS), Medicare Benefits Schedule (MBS), MedicineInsight general practice reports and Community Pharmacy Agreements.
References:
- Atkins, ER, et al. The cost of treating hypertension in Australia, 2012-22: an economic analysis. Medical Journal of Australia. doi: 10.5694/mja2.52522
- Australian Bureau of Statistics. https://www.abs.gov.au/statistics/health/health-services/patient-experiences/2021-22. Accessed November 2024
- Hird TR, Zomer E, Owen AJ, Magliano DJ, Liew D, Ademi ZJH. Productivity burden of hypertension in Australia: a life table modeling study. Hypertension 2019; 73(4): 777-84
- Carnagarin R, et al. May Measurement Month 2018: an analysis of blood pressure screening results from Australia. Eur Heart J Suppl 2020; 22: H17-h9. doi: 10.1093/eurheartj/suaa018
- Zhou B, Carrillo-Larco RM, Danaei G, et al. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet 2021; 398(10304): 957-80
- National Hypertension Taskforce of Australia. Accessed November 2024
