Cost-utility of expanded hypertension screening and treatment among adults covered by Peru's Seguro integral de salud: a markov Model using national data

BACKGROUND: We assessed the cost-utility of expanding hypertension screening, diagnosis, and treatment among adults covered by Peru's Seguro Integral de Salud (SIS). RESEARCH DESIGN AND METHODS: Analyses assembled in May 2026 used a 10-year cohort Markov model parameterized with the 2024 Peruvian Demographic and Family Health Survey (ENDES), SIS administrative data for 2022-2024, and published parameters. Universal and risk-targeted scenarios were compared with population-specific usual care, using S/ 25,007 per quality-adjusted life-year (QALY). RESULTS: The baseline sample included 6,098 adults aged 40-74 years; hypertension prevalence was 28.9%. Universal 80-80-80 expansion averted 60.7 cardiovascular events and 6.1 cardiovascular deaths and gained 51.3 QALYs per 100,000 eligible adults. Incremental cost was S/ 7,784,979, with an incremental cost-effectiveness ratio (ICER) of S/ 151,686/QALY. The scenario targeting 10-year cardiovascular risk ≥ 10% had an ICER of S/ 60,171/QALY in its eligible subgroup. CONCLUSIONS: All scenarios exceeded the threshold. Lower targeted-scenario ICERs concern different eligible populations. Estimates depend on modeled effects, the 10-year horizon, and exclusion of event-related savings.