Key result
Renal denervation proves cost-effective vs standard care, costing ~69% below willingness-to-pay thresholds.
Why the study?
Renal denervation is recommended for managing arterial hypertension, and this study aimed to systematically assess its cost-effectiveness.
Does renal denervation plus standard of care improve cost-effectiveness (ICER per QALY gained compared to WTP thresholds) compared to standard of care alone in patients with arterial hypertension?
Meta-Analysis
Yes
Does renal denervation plus standard of care improve cost-effectiveness (ICER per QALY gained compared to WTP thresholds) compared to standard of care alone in patients with arterial hypertension?
Renal denervation added to standard of care is a cost-effective intervention for patients with resistant or uncontrolled arterial hypertension, particularly in those at high cardiovascular risk.
Renal denervation meets cost-effectiveness thresholds across systems; confirms and reinforces guideline recommendations for hypertension.
Background/Introduction Renal denervation (RDN) is recommended for the management of arterial hypertension. Purpose The aim of this study was to assess the cost-effectiveness of RDN. Methods A systematic review/meta-analysis was conducted to identify RDN cost-effectiveness studies. The Incremental Cost-Effectiveness Ratio (ICER) per one Quality-Adjusted Life Year (QALY) gained (the extra cost needed for one additional year of good quality life) were compared to the respective country-specific Willingness to Pay (WTP) Thresholds (the maximum ICER/QALY gained that is considered acceptable by a healthcare system or organization for an intervention to be deemed cost-effective). Results Nineteen studies (16 countries) were included, all in favor of RDN cost-effectiveness. Most studies (n=12/19, 63%) were conducted after 2024, half in the context of European economic/healthcare systems. All studies implemented decision-analytic Markov models and compared RDN (mainly radiofrequency) plus standard of care (SoC) vs SoC alone. Meta-analysis of 7 studies indicated a pooled ICER/QALY gained 22209 €, compared to WTP Threshold 50000 €, thereby indicating the cost-effectiveness of RDN. Meta-analysis of 19 studies indicated a pooled ICER/QALY gained to WTP Threshold ratio of 0.31 (0.20, 0.44) (Figure). In sensitivity analyses RDN was shown to be cost-effective in both resistant and uncontrolled hypertensive patients especially in those with high cardiovascular risk and considering longer time horizons. Most studies were deemed to have low risk of bias. Conclusion(s) In line with guidelines recommendations, RDN appears to be a cost-effective intervention across a variety of clinical scenarios, both for patients with resistant or uncontrolled hypertension and especially in young and/or high cardiovascular risk patients.
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Kyriakoulis et al. (2026) conducted a meta-analysis in Arterial hypertension (resistant or uncontrolled). Renal denervation (RDN) plus standard of care (SoC) vs. Standard of care (SoC) alone was evaluated on Incremental Cost-Effectiveness Ratio (ICER) per Quality-Adjusted Life Year (QALY) gained to Willingness to Pay (WTP) Threshold ratio (ICER/QALY to WTP ratio 0.31, 95% CI 0.20-0.44). Renal denervation plus standard of care was cost-effective vs standard of care alone, with a pooled ICER/QALY of €22,209 and an ICER/WTP threshold ratio of 0.31 (0.20-0.44).
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