Communications medicine · 2026
Estimating investment costs to improve hypertension care in Lagos, Nigeria.
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Dieteren Charlotte M, Gómez-Pérez Gloria P, Bellaar Atze, Banigbe Bolanle, Ifeanyichi Martilord, Rinke de Wit Tobias F, Dada Ibironke, Zamba Emmanuella, van Andel Judith M
Аннотация
BACKGROUND: Low- and middle-income countries (LMICs) house 66% of all hypertension patients, many of whom are undertreated, leading to severe health risks and higher healthcare costs. This study examined the required investments to improve hypertension control in Lagos, Nigeria, using real-world medical records and cost data.
METHODS: We analyzed routine medical records from 1249 hypertension patients across 74 public and private facilities in Lagos State and combined these with facility-level cost data to estimate the investment required to deliver guideline-based care. Patient-level gaps were extrapolated to the state level using prevalence-based scenarios, and linear random effects regression was used to assess associations between care completeness and blood pressure change.
RESULTS: We found that adherence to consultations and medications according to guidelines was significantly associated with a 5-6 mmHg reduction in systolic blood pressure. These reductions correspond to a 6-14% decrease in cardiovascular complication risk and would require an average annual investment of USD 120 per patient. Medications are the main cost driver. Statewide, providing complete care for all hypertension patients would require a yearly investment of $300 million, or $5000 to $13,000 per saved life year.
CONCLUSIONS: The identified required investments are currently far outside an acceptable range when compared to the Gross Domestic Product (GDP) of Lagos State, Nigeria. To make chronic care investments feasible, hypertension management must become more efficient, including reducing high medication costs through bulk purchasing, adopting innovative, group-based blended care models, and increasing health insurance coverage.
METHODS: We analyzed routine medical records from 1249 hypertension patients across 74 public and private facilities in Lagos State and combined these with facility-level cost data to estimate the investment required to deliver guideline-based care. Patient-level gaps were extrapolated to the state level using prevalence-based scenarios, and linear random effects regression was used to assess associations between care completeness and blood pressure change.
RESULTS: We found that adherence to consultations and medications according to guidelines was significantly associated with a 5-6 mmHg reduction in systolic blood pressure. These reductions correspond to a 6-14% decrease in cardiovascular complication risk and would require an average annual investment of USD 120 per patient. Medications are the main cost driver. Statewide, providing complete care for all hypertension patients would require a yearly investment of $300 million, or $5000 to $13,000 per saved life year.
CONCLUSIONS: The identified required investments are currently far outside an acceptable range when compared to the Gross Domestic Product (GDP) of Lagos State, Nigeria. To make chronic care investments feasible, hypertension management must become more efficient, including reducing high medication costs through bulk purchasing, adopting innovative, group-based blended care models, and increasing health insurance coverage.