Cost-Effective Hypertension Management: Comparison of Drug Therapies With an Alternative Program

The American Journal of Managed Care, Vol. 2, pp. 427-437, 1996.

Robert E. Herron, PhD,* Robert H. Schneider, MD,** Joseph V. Mandarino, PhD, Charles N. Alexander, PhD,** and Kenneth G. Walton, PhD.

Conducted at
**Institute of Science, Technology and Public Policy, and
**Center for Health and Aging Studies, Department of Physiological and Biological Sciences, and
Department of Management, and
Departments of Chemistry and Physiology, Maharishi University of Management, Fairfield, IA


The competitive nature of managed care organizations demands that providers seek cost-effective ways to maintain the health of their clients. As an approach to reducing cardiovascular morbidity and mortality, antihypertensive medication is costly, has adverse side effects, and has questionable value in reducing coronary heart disease. This report evaluates a behavioral stress-reduction method as an option to pharmaceutical treatment. Randomized studies indicate that the Transcendental Meditation® (TM®) technique reduces mild hypertension (the predominant form of hypertension) as effectively as do drug therapies. A cost-effectiveness comparison in 1996 dollars was conducted among five standard antihypertensive medications and the TM® technique over a simulated 20-year treatment period. According to present value analysis of treatment payments, the TM® technique had the lowest present value cost, and thus appeared to be the most attractive alternative. The estimated average cost of antihypertensive drug treatment ranged from $375 per year for hydrochlorothiazide to $1,051 per year for propranolol hydrochloride, whereas the estimated average cost of treatment with the TM® technique was $286 per year. When combined with results of controlled trials documenting the effectiveness of the TM® technique in reducing high blood pressure, decreasing morbidity and mortality, and improving the quality of life, the present comparison suggests that this nonpharmacologic procedure may be safely used as a cost-effective treatment of hypertension in the managed care setting.

Abstract reprinted by permission of The American Journal of Managed Care. Copyright 1996. All rights reserved.

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