Herron, R. E., Schneider, R. H., Mandarino, J. V., Alexander, C. N., Walton, K. G.
The competitive nature of managed care organizations demands that providers seek cost-effective ways to maintain the health of their clients. As an approach to reducing cardiovascular morbidity, anti-hypertensive medication is costly, has adverse side effects, and has questionable value in reducing coronary heart disease. This report evaluates a behavioral stress-reduction method as an option to pharmaceutical treatment. Randomized studies indicate that the Transcendental Meditation® (TM) technique reduces mild hypertension (the predominant form of hypertension) as effectively as drug therapies. A cost-effectiveness comparison in 1996 dollars was made between five standard antihypertensive medications and the TM technique over a simulated twenty-year treatment period. The present value analysis of treatment payments found that the TM technique had the lowest present value cost, and thus appeared to be the most attractive alternative. The estimated average costs of anti-hypertensive drug treatment ranged from $375 per year for hydrochlorothiazide to $1051 per year for propranolol hydrochloride, whereas the estimated average cost of treatment with the TM technique was $286 per year. When combined with results of controlled trials documenting the effectiveness of the TM technique in reducing high blood pressure and improving the quality of life, the present comparison suggests this non-pharmacologic procedure may be safely used as a cost-effective treatment of hypertension in the managed care setting.
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