ArticleApplied health economics and health policy2026
An Early Value Assessment of Biomarker-Guided Precision Medicine for Treatment-Resistant Hypertension: A Headroom and Threshold Analysis.
Article in Applied health economics and health policy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTreatment-resistant hypertension (TRH), defined as uncontrolled blood pressure despite the use of three or more antihypertensive drugs or requiring four or more drugs for control, affects 10.3% of patients with hypertension and increases cardiovascular risk. Biomarker-guided precision treatments have the potential to address unmet needs in TRH. This health economic modelling study assessed the headroom (that is the maximum potential value of a hypothetical biomarker-guided treatment strategy with zero treatment costs and 100% effectiveness) in the TRH population in general, then in a specific subgroup with elevated levels of NADPH oxidase 5 (NOX5-positive).
methodsA decision tree and a state transition model were developed to estimate headroom in patients with TRH and in the NOX5-positive subgroup (assumed to comprise 25% of the population). The model adopted a Dutch healthcare perspective over a lifetime horizon, estimating costs and quality-adjusted life years (QALYs), with a net monetary benefit threshold of €20,000 per QALY. Uncertainty was explored through sensitivity, scenario and threshold analyses.
resultsThe room for improvement in TRH patients includes 2.94 additional life years, 3.45 QALYs, and €23,292 cost savings per patient. Successfully diagnosing and treating NOX5-positive patients could yield a gain of 0.53 life years and 0.63 QALYs, with cost savings of €4835 per patient. The biomarker-guided treatment remained cost effective even at annual costs of €5045 per patient or if only two of 1000 patients were NOX5-positive and successfully treated.
conclusionPatients with TRH have room for improvement in life expectancy, quality of life, and cardiovascular outcomes with a biomarker-guided treatment strategy. These findings support further research and development of targeted treatments to address this unmet medical need.
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