Cost-Effectiveness Analysis of the TDM-Guided
Approach to Diagnosing PA
Based on the assumptions provided in the decision model and the prevalence rate of PA in TDM-determined adherent patients (27.5%), TDM-guided PA
screening was associated with a $590.69 lower cost per patient compared with unselective PA screening ($1042.02 vs $1632.71, respectively). Because our decision model did not subject nonadherent patients to further investigation for PA or any form of secondary hypertension, as expected, TDM-guided PA screening was less effective in identifying PA cases than the unselective screening strategy. Nevertheless, TDMguided PA screening was associated with a lower rate of detection of PA by only 3.8% of the patients compared with the unselective PA screening strategy (11% vs 14.8%, respectively). Furthermore, TDMguided
screening was associated with a lower rate of unnecessary PA screening compared with unselective PA screening (35% vs 85.2%, respectively).