Cost-effectiveness of renal denervation vs. pharmacotherapy for treatment-resistant hypertension in low-resource settings

Drug-resistant hypertension is a major issue in low-resource healthcare systems. The aim of this study was to identify the cost-effectiveness of renal denervation versus optimal drug treatment in resistant hypertensive patients in low-resource settings. It was a prospective clinical trial with Markov model in 290 Uzbekistan patients. Patients were randomly allocated into two intervention groups (renal denervation and drug therapy) and one control group (optimal drug therapy alone). Key results were change in blood pressure and cost-effectiveness analysis with 10-year time horizon. The results showed that renal denervation caused an additional decrease in systolic blood pressure of 1.10 mmHg compared to the control group at 24 months. The rate of blood pressure control was also greater in the intervention group. From a cost perspective, even though it cost more initially, the denervation treatment was cheaper in the long term with an incremental cost-effectiveness ratio of $4150 per QALY. The final conclusion suggests renal denervation is not only a more effective treatment but also a cost-effective method in resistant hypertension therapy in resource-poor settings such as Uzbekistan. Adding this technology to the health care package can lead to improved cardiovascular outcomes and optimize the utilization of limited health resources.