{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:58:25Z","timestamp":1790614705166,"version":"4.1.0"},"reference-count":26,"publisher":"Pan American Health Organization","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,31]]},"abstract":"<title>ABSTRACT<\/title>\n                  <sec>\n                    <title>Objective.<\/title>\n                    <p>To estimate the economic impact of standard pharmacological treatment for hypertension on a typical household in Argentina using a new indicator relating treatment costs to household income.<\/p>\n                  <\/sec>\n                  <sec>\n                    <title>Methods.<\/title>\n                    <p>A longitudinal study was conducted from December 2019 to December 2024. The standard Argentine antihypertensive treatment (amlodipine 5 mg and losartan 50 mg) was selected. Retail prices of these drugs, both as single-drug combinations and fixed-dose combinations, were obtained from the publicly available Kairos database. The Standard Treatment Economic Impact Index was developed to express monthly out-of-pocket expenditure as a proportion of the total basic basket published by Argentina\u2019s National Institute of Statistics and Censuses. Analyses were stratified by household health coverage status \u2013 with or without formal coverage.<\/p>\n                  <\/sec>\n                  <sec>\n                    <title>Results.<\/title>\n                    <p>Marked differences were seen in household costs by coverage status. Among households with health coverage, antihypertensive treatment costs represented 2.04%\u20133.39% of the total basic basket, placing expenditure below catastrophic health expenditure thresholds throughout the study. For households without health coverage, the index ranged from 6.81% to 11.31% of the total basic basket, which was above at least one of the catastrophic health expenditure thresholds used, and sometimes above both. Throughout the study, single-drug combinations were more expensive than fixed-dose combinations.<\/p>\n                  <\/sec>\n                  <sec>\n                    <title>Conclusions.<\/title>\n                    <p>These findings indicate a substantial financial burden for families without formal health coverage when accessing essential antihypertensive therapy. By focusing on treatment affordability rather than total household expenditure, the index may help anticipate and prevent future catastrophic health spending, particularly among uninsured populations.<\/p>\n                  <\/sec>","DOI":"10.26633\/rpsp.2026.79","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:29:18Z","timestamp":1788186558000},"page":"1","source":"Crossref","is-referenced-by-count":1,"title":["Economic impact of standardized hypertension treatment on household income in Argentina: a longitudinal analysis, 2019\u20132024"],"prefix":"10.26633","volume":"50","author":[{"given":"Santiago","family":"Torroba","sequence":"first","affiliation":[{"name":"Department of Health and Social Security, Poliedro Foundation, Buenos Aires, Argentina."},{"name":"storroba@gmail.com"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilario","family":"Bielsa","sequence":"additional","affiliation":[{"name":"Department of Health and Social Security, Poliedro Foundation, Buenos Aires, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasim","family":"Iusef Venturini","sequence":"additional","affiliation":[{"name":"University Center for Pharmacology, School of Medical Sciences, National University of La Plata, Buenos Aires, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Requejo","sequence":"additional","affiliation":[{"name":"Department of Health and Social Security, Poliedro Foundation, Buenos Aires, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julieta","family":"Arilla","sequence":"additional","affiliation":[{"name":"Department of Health and Social Security, Poliedro Foundation, Buenos Aires, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mart\u00edn Pont","family":"Verges","sequence":"additional","affiliation":[{"name":"Department of Health and Social Security, Poliedro Foundation, Buenos Aires, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11167","reference":[{"key":"ref1","unstructured":"Pan American Health Organization. ENLACE: data portal on noncommunicable diseases, mental health, and external causes [internet]. Washington, DC: PAHO [cited 2025 May 23]. Available from: https:\/\/www.paho.org\/en\/enlace"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Joseph P, Lanas F, Roth G, Lopez-Jaramillo P, Lonn E, Miller V, et al. Cardiovascular disease in the Americas: the epidemiology of cardiovascular disease and its risk factors. Lancet Reg Health Am. 2025;42:100960. http:\/\/doi.org\/10.1016\/j.lana.2024.100960","DOI":"10.1016\/j.lana.2024.100960"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Magnussen C, Ojeda FM, Leong DP, Alegre-Diaz J, Amouyel P, Aviles-Santa L, et al.; Global Cardiovascular Risk Consortium. Global effect of modifiable risk factors on cardiovascular disease and mortality. N Engl J Med. 2023;389(14):1273\u201385. http:\/\/doi.org\/10.1056\/NEJMoa2206916","DOI":"10.1056\/NEJMoa2206916"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"GBD 2023 Chronic Kidney Disease Collaborators. Global, regional, and national burden of chronic kidney disease in adults, 1990\u20132023, and its attributable risk factors: a systematic analysis for the Global Burden of Disease Study 2023. Lancet. 2025;406(10518):2461\u201382. http:\/\/doi.org\/10.1016\/S0140-6736(25)01853-7","DOI":"10.1016\/S0140-6736(25)01853-7"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Moran AE, Gupta R; Global Hearts Initiative Collaborators. Implementation of Global Hearts Hypertension Control Programs in 32 low- and middle-income countries: JACC International. J Am Coll Cardiol. 2023;82(19):1868\u201384. http:\/\/doi.org\/10.1016\/j.jacc.2023.08.043","DOI":"10.1016\/j.jacc.2023.08.043"},{"key":"ref6","unstructured":"Ministerio de Salud de la Naci\u00f3n. Bolet\u00edn de mortalidad por enfermedades no transmisibles, per\u00edodo 1997\u20132022 [Bulletin on mortality from noncommunicable diseases, 1997\u20132022] [internet]. Buenos Aires: Ministerio de Salud de la Naci\u00f3n; 2024 [cited 2025 May 27]. Available from: https:\/\/www.argentina.gob.ar\/sites\/default\/files\/boletin_ent_3.pdf"},{"key":"ref7","unstructured":"Instituto Nacional de Estad\u00edstica y Censos, Secretar\u00eda de Gobierno de Salud de la Naci\u00f3n. 4\u00b0 Encuesta Nacional de Factores de Riesgo: resultados definitivos [4th National Survey of Risk Factors. final results]. Buenos Aires: INDEC; 2019 [cited 2025 May 27]. Available from: https:\/\/www.indec.gob.ar\/ftp\/cuadros\/publicaciones\/enfr_2018_resultados_definitivos.pdf"},{"key":"ref8","unstructured":"Pan American Health Organization. Monitoring and evaluation framework for hypertension control programs. Washington, DC: PAHO; 2018 [cited 27 May 2025]. Available from: https:\/\/iris.paho.org\/handle\/10665.2\/34877"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Martinez R, Soliz P, Campbell NRC, Lackland DT, Whelton PK, Ordunez P. Association between population hypertension control and ischemic heart disease and stroke mortality in 36 countries of the Americas, 1990\u20132019: an ecological study. Rev Panam Salud Publica. 2022;46:e143. http:\/\/doi.org\/10.26633\/RPSP.2022.143","DOI":"10.26633\/RPSP.2022.143"},{"key":"ref10","unstructured":"Secretar\u00eda de Salud de la Naci\u00f3n. Plan Nacional de Prevenci\u00f3n y Control de la Hipertensi\u00f3n Arterial: adherido a la iniciativa HEARTS de OPS\/OMS [National Plan for the Prevention and Control of Hypertension: adhering to the PAHO\/WHO HEARTS initiative. Buenos Aires: Secretar\u00eda de Salud de la Naci\u00f3n; 2019 [cited 2025 May 27]. Available from: https:\/\/www.argentina.gob.ar\/sites\/default\/files\/bancos\/2023-10\/plan-nacional-prevencion-control-de-la-hipertension-arterial.pdf"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Ordunez P, Campbell NRC, Giraldo Arcila GP, Angell SY, Lombardi C, Brettler JW, et al. HEARTS in the Americas: innovations for improving hypertension and cardiovascular disease risk management in primary care. Rev Panam Salud Publica. 2022;46:e96. https:\/\/doi.org\/10.26633\/RPSP.2022.96","DOI":"10.26633\/RPSP.2022.96"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Souza KM, Giron N, Vallini J, Hallar K, Ordunez P, Rosende A, et al. Barriers to access to antihypertensive medicines: insights from the HEARTS initiative in Latin American and Caribbean region. J Pharm Policy Pract. 2024;17(1):2379045. http:\/\/doi.org\/10.1080\/20523211.2024.2379045","DOI":"10.1080\/20523211.2024.2379045"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Fang J, Chang T, Wang G, Loustalot F. Association between cost-related medication nonadherence and hypertension management among US adults. Am J Hypertens. 2020;33(9):879\u201386. https:\/\/doi.org\/10.1093\/ajh\/hpaa072","DOI":"10.1093\/ajh\/hpaa072"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Conrad P. The meaning of medications: another look at compliance. Soc Sci Med. 1985;20(1):29\u201337. http:\/\/doi.org\/10.1016\/0277-9536(85)90308-9","DOI":"10.1016\/0277-9536(85)90308-9"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Crowley MJ, Grubber JM, Olsen MK, Bosworth HB. Factors associated with non-adherence to three hypertension self-management behaviors: preliminary data for a new instrument. J Gen Intern Med. 2013;28(1):99\u2013106. http:\/\/doi.org\/10.1007\/s11606-012-2195-1","DOI":"10.1007\/s11606-012-2195-1"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Tajeu GS, Muntner P. Cost-related antihypertensive medication nonadherence: action in the time of COVID-19 and beyond. Am J Hypertens. 2020;33(9):816\u20138. http:\/\/doi.org\/10.1093\/ajh\/hpaa085","DOI":"10.1093\/ajh\/hpaa085"},{"key":"ref17","unstructured":"Instituto Nacional de Estad\u00edstica y Censos. Incidencia de la pobreza y la indigencia en 31 aglomerados urbanos. Segundo semestre de 2024 [Incidence of poverty and extreme poverty in 31 urban areas. Second half of 2024]. Buenos Aires: INDEC; 2024 [cited 2025 May 27]. Available from: https:\/\/www.indec.gob.ar\/uploads\/informesdeprensa\/eph_pobreza_03_252282AE14D2.pdf"},{"key":"ref18","unstructured":"Knaul FM, Wong R, Arreola-Ornelas H, editors. Financing health in Latin America, vol. 1: household spending and impoverishment. Cambridge, MA: Harvard Global Equity Initiative; 2012."},{"key":"#cr-split#-ref19.1","unstructured":"WHO Collaborating Centre for Drug Statistics Methodology. ATC\/DDD Index 2024 [internet]. Oslo: WHO Collaborating Centre for Drug Statistics Methodology"},{"key":"#cr-split#-ref19.2","unstructured":"2024 [cited 2025 May 27]. Available from: https:\/\/www.whocc.no\/atc_ddd_index\/"},{"key":"ref20","unstructured":"Urtasun MA, Regueiro AJ, Ca\u00f1as M, Gaido Stulle EJ, Estigarribia NA, Bustin J, et al. Estimaci\u00f3n de prevalencia de uso de medicamentos antihipertensivos en el programa de atenci\u00f3n m\u00e9dico integral para adultos mayores de Argentina [Estimate of prevalence of antihipertensive drugs used in the Argentinian Integral Health Care Program for Elderly People]. Rev Argent Salud Publica. 2020;11(42):32\u20139."},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"DeCarolis DD, Gravely A, Olney CM, Ishani A. Impact of antihypertensive drug class on outcomes in SPRINT. Hypertension. 2022;79(5):1112\u201321. http:\/\/doi.org\/10.1161\/HYPERTENSIONAHA.121.18369","DOI":"10.1161\/HYPERTENSIONAHA.121.18369"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Brant LCC, Passaglia LG, Pinto-Filho MM, de Castilho FM, Ribeiro ALP, Nascimento BR. The burden of resistant hypertension across the world. Curr Hypertens Rep. 2022;24(3):55\u201366. http:\/\/doi.org\/10.1007\/s11906-022-01173-w","DOI":"10.1007\/s11906-022-01173-w"},{"key":"ref23","unstructured":"Varco MJ, Campod\u00f3nico IM, de los Reyes L, Laurenza M, Levcovich M. Gasto catastr\u00f3fico y empobrecedor en salud: un estudio para Argentina [Catastrophic and impoverishing expenditure: a study from Argentina]. Rev Argent Salud Publica. 2022;14:e71."},{"key":"ref24","unstructured":"Instituto Nacional de Estad\u00edstica y Censos. censo nacional de poblaci\u00f3n, hogares y viviendas 2022 Resultados definitivos [National population, household and housing census 2022: definitive results]. Buenos Aires: INDEC; 2023 [cited 2025 May 27]. Available from: https:\/\/censo.gob.ar\/"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Nguyen HA, Ahmed S, Turner HC. Overview of the main methods used for estimating catastrophic health expenditure. Cost Eff Resour Alloc. 2023;21:50. http:\/\/doi.org\/10.1186\/S12962-023-00457-5","DOI":"10.1186\/s12962-023-00457-5"}],"container-title":["Revista Panamericana de Salud P\u00fablica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/iris.paho.org\/bitstreams\/0dcf0fba-cd4d-46dd-a4ab-f13f11fd8b78\/download","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:29:22Z","timestamp":1788186562000},"score":1,"resource":{"primary":{"URL":"https:\/\/iris.paho.org\/handle\/10665.2\/72108"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":26,"alternative-id":["RPSP.2026.79"],"URL":"https:\/\/doi.org\/10.26633\/rpsp.2026.79","relation":{},"ISSN":["1020-4989","1680-5348"],"issn-type":[{"value":"1020-4989","type":"print"},{"value":"1680-5348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]}}}