The Economic Burden of Hypertension among Older Persons: Lessons from a Developing Nation

Background: Three out of every four hypertensive persons live in developing countries where they contribute significantly to increased healthcare consumption and disability; this is particularly true amongst older persons. With a rapidly ageing population, the economic burden of hypertension (HTN) in Jamaica is projected to continue trending upwards with significant implications for healthcare costs in an economy experiencing low growth. Estimating the economic burden of HTN is, therefore, important from a planning and mitigation perspective.  Methods: Cost analysis methods were undertaken to estimate absolute costs, in both direct and indirect terms.   Results: Absolute economic burden was estimated at US$204.7 million; direct cost was $116.2 million (57%) and the indirect was $88.5 million (43%). Major cost drivers were laboratory investigations (29%), medications (18%), hospitalization (5%), and consultations (4%). Indirect costs were driven primarily by the need for a caregiver ($71.4 million); this need was the largest overall driver of HTN cost at 35%. Over 2,400 productive years were lost from this population at an estimated cost of $17.1 million. The burden amongst this sub-population represents 27.6% of Total Health Expenditure and per capita health expenditure of almost three times more than the general population.  Conclusions: The economic burden of HTN amongst older adults is high for both the country and for individuals. This burden stresses an already resource-stretched, underfunded health sector reducing its ability to provide quality care and acting as one additional barrier to the goal of universal health coverage. Exploration into policy measures to address this burden is, therefore, critical.