Renal denervation for hypertension: cross-country cost-effectiveness insights from mainland China, Japan, and Thailand

Abstract Background Renal denervation (RDN) has been introduced as a novel non-pharmacological intervention for patients with hypertension that is poorly controlled by pharmacological means. Our study aims to evaluate the cost-effectiveness of the Netrod RDN treatment plus antihypertensives compared...

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Main Authors: Dai Lian, Yue Suo, Ruoyan Gai, Ning li, Yunfeng Ren, Dunming Xiao, Jiaxin Zhao, Mingdong Zhang, Shimeng Liu, Yingyao Chen
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Health Economics Review
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Online Access:https://doi.org/10.1186/s13561-025-00669-w
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author Dai Lian
Yue Suo
Ruoyan Gai
Ning li
Yunfeng Ren
Dunming Xiao
Jiaxin Zhao
Mingdong Zhang
Shimeng Liu
Yingyao Chen
author_facet Dai Lian
Yue Suo
Ruoyan Gai
Ning li
Yunfeng Ren
Dunming Xiao
Jiaxin Zhao
Mingdong Zhang
Shimeng Liu
Yingyao Chen
author_sort Dai Lian
collection DOAJ
description Abstract Background Renal denervation (RDN) has been introduced as a novel non-pharmacological intervention for patients with hypertension that is poorly controlled by pharmacological means. Our study aims to evaluate the cost-effectiveness of the Netrod RDN treatment plus antihypertensives compared with antihypertensives alone for hypertension in Mainland China, Japan and Thailand. Methods A Markov decision-analytic model was developed to simulate the long-term clinical events, quality-adjusted life years (QALYs) and related costs among patients who underwent RDN regimen and antihypertensive regimen in line with Netrod-HTN trial, with yearly cycles over a 30-year horizon. This study adopted the perspectives of the healthcare systems. Cost and utility inputs were collected from published literature, price databases, expert consultations, and hospital information systems. Both costs and outcomes were discounted at a rate of 5%. Model validation, univariate and probabilistic sensitivity analyses, and scenario analyses were conducted to verify the robustness of the results. Results Compared with the antihypertensive regimen alone, the RDN regimen yielded a 30.61% reduction in cardiovascular, cerebral and renal events. Cost-effectiveness analysis showed the RDN regimen yielded the most favorable incremental cost-effectiveness ratio in Japan at $3,451 per QALY, followed by Thailand at $13,932 per QALY, and Mainland China at $19,049 per QALY. Sensitivity and scenario analyses confirmed the robustness of the findings. Conclusions Netrod RDN is a cost-effective intervention from the healthcare system perspective in Mainland China, Japan, and Thailand. However, its cost-effectiveness varies across countries, reflecting differences in socioeconomic contexts. In middle- and low-income countries, appropriate pricing strategies may play a key role in enhancing its affordability and cost-effectiveness.
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spelling doaj-art-43314c72baf24fcaaf282dc3869a15412025-08-20T03:42:37ZengBMCHealth Economics Review2191-19912025-08-0115111510.1186/s13561-025-00669-wRenal denervation for hypertension: cross-country cost-effectiveness insights from mainland China, Japan, and ThailandDai Lian0Yue Suo1Ruoyan Gai2Ning li3Yunfeng Ren4Dunming Xiao5Jiaxin Zhao6Mingdong Zhang7Shimeng Liu8Yingyao Chen9School of Public Health, Fudan UniversitySchool of Public Health, Fudan UniversityOffice for Global Relations, Nagasaki UniversitySchool of Integrated Innovation, Chulalongkorn UniversitySchool of Public Health, Fudan UniversitySchool of Public Health, Fudan UniversitySchool of Public Health, Fudan UniversitySchool of Public Health, Fudan UniversitySchool of Public Health, Fudan UniversitySchool of Public Health, Fudan UniversityAbstract Background Renal denervation (RDN) has been introduced as a novel non-pharmacological intervention for patients with hypertension that is poorly controlled by pharmacological means. Our study aims to evaluate the cost-effectiveness of the Netrod RDN treatment plus antihypertensives compared with antihypertensives alone for hypertension in Mainland China, Japan and Thailand. Methods A Markov decision-analytic model was developed to simulate the long-term clinical events, quality-adjusted life years (QALYs) and related costs among patients who underwent RDN regimen and antihypertensive regimen in line with Netrod-HTN trial, with yearly cycles over a 30-year horizon. This study adopted the perspectives of the healthcare systems. Cost and utility inputs were collected from published literature, price databases, expert consultations, and hospital information systems. Both costs and outcomes were discounted at a rate of 5%. Model validation, univariate and probabilistic sensitivity analyses, and scenario analyses were conducted to verify the robustness of the results. Results Compared with the antihypertensive regimen alone, the RDN regimen yielded a 30.61% reduction in cardiovascular, cerebral and renal events. Cost-effectiveness analysis showed the RDN regimen yielded the most favorable incremental cost-effectiveness ratio in Japan at $3,451 per QALY, followed by Thailand at $13,932 per QALY, and Mainland China at $19,049 per QALY. Sensitivity and scenario analyses confirmed the robustness of the findings. Conclusions Netrod RDN is a cost-effective intervention from the healthcare system perspective in Mainland China, Japan, and Thailand. However, its cost-effectiveness varies across countries, reflecting differences in socioeconomic contexts. In middle- and low-income countries, appropriate pricing strategies may play a key role in enhancing its affordability and cost-effectiveness.https://doi.org/10.1186/s13561-025-00669-wRenal denervationCost-effectivenessHypertensionMainland ChinaJapanThailand
spellingShingle Dai Lian
Yue Suo
Ruoyan Gai
Ning li
Yunfeng Ren
Dunming Xiao
Jiaxin Zhao
Mingdong Zhang
Shimeng Liu
Yingyao Chen
Renal denervation for hypertension: cross-country cost-effectiveness insights from mainland China, Japan, and Thailand
Health Economics Review
Renal denervation
Cost-effectiveness
Hypertension
Mainland China
Japan
Thailand
title Renal denervation for hypertension: cross-country cost-effectiveness insights from mainland China, Japan, and Thailand
title_full Renal denervation for hypertension: cross-country cost-effectiveness insights from mainland China, Japan, and Thailand
title_fullStr Renal denervation for hypertension: cross-country cost-effectiveness insights from mainland China, Japan, and Thailand
title_full_unstemmed Renal denervation for hypertension: cross-country cost-effectiveness insights from mainland China, Japan, and Thailand
title_short Renal denervation for hypertension: cross-country cost-effectiveness insights from mainland China, Japan, and Thailand
title_sort renal denervation for hypertension cross country cost effectiveness insights from mainland china japan and thailand
topic Renal denervation
Cost-effectiveness
Hypertension
Mainland China
Japan
Thailand
url https://doi.org/10.1186/s13561-025-00669-w
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